Consent Form for Psychological Treatment of a Minor

Whenever a therapist or counselor has to give treatment to a minor of any type, he will have to contact the parents or guardians of that minor to get information to start the treatment. A minor is a child who is under 18 and cannot decide on his own whether to get the treatment and from where.

Therefore, their guardians have to take the onus of making this critical decision, and they are given the consent form to fill out before a psychologist has a look at the form and decides to start the treatment.

In this part, the parents or caregivers clearly state that they allow the mental healthcare practitioner to start the treatment and decide on the medication and treatment they should administer to the child.

When should I use the form to get permission from psychologists?

People who want their kid to be treated by a psychologist have to confront this form when they reach the clinic along with their child and express their interest in giving him the treatment. As soon as they have registered the child in the clinic of the psychologist, they will have to fill out this form and give consent.

Who can give consent?

Usually, parents are asked to permit them to start the treatment. In some cases, parents are not around, and they have given the authority to someone to act on their behalf and allow the doctor to initiate the treatment of mental health.

That person has to show the letter of authority to prove his authority, and then he can act on behalf of the child’s parents to give permission. The one who gives permission needs to be very careful, as the treatment might put the life of a minor at risk and things can go wrong.

Consent Form for Psychological Treatment of a Minor

Consent Form File: 124 KB

What do you see in the permission form used by a psychiatrist clinic for kids?

Information on the form:

At the top of the form, there is the name and logo of the clinic or hospital where the patient has come for treatment. This shows the patient that this is an authentic document, as the logo is an indication that the form belongs to the hospital. 

Information about the patient (minor):

A person who has to give consent should provide the details of the child for whom the permission is being given. Here, the name, age, date of birth, gender, etc. should be provided.

Information about the guardian:

A clinic needs to know who is permitting the medical staff to start the treatment and who can be held accountable for the permission. Doctors also keep in touch with that person for follow-up checkups and further treatment because the one who gives the permission is also someone who has the responsibility to take care of the child. The information of the authorizer includes their name, age, gender, relationship with the child, address, phone number, etc.

Consent clause:

There is a section at the end that is allocated to the consent part only. Here, different clauses are mentioned, and the person who has to release consent should read all those clauses carefully before he signs this form.

These clauses are about how the treatment will be given to the child, what are the worst-case scenarios the person authorizing the psychologist should keep in mind, what are the rights and responsibilities of the patient and his family, what are the repercussions for not providing accurate information, and a lot of other clauses that depend on the specific situation of the hospital.

Template for the consent form:

It is easy for a person to get their hands on a template for the consent form, as it is one of the most commonly used documents in healthcare facilities. It can be found and downloaded easily. However, the problem is often with the content, which may not be aligned with the needs of the hospital.

In that case, the psychologist can edit the form template and customize it to make it look more relevant for the mental treatment of the minor at his clinic. This way, the information he can collect can be very helpful for him.

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