Consent for Treatment of Minor form

Consent for Treatment of Minor

Lexington Eye Associates strongly encourages that a parent or legal guardian accompany any minor children (17 years old or younger) to their medical appointments.

In the event that a parent or legal guardian is unable to accompany his or her minor child to a medical appointment, the parent or legal guardian should either (1) sign this Consent for Non-Emergency Treatment of Minors and send it to Lexington Eye Associates prior to the medical appointment or (2) give it to the minor child to present to Lexington Eye Associates at the time of the medical appointment.

In the event that a minor child presents for a non-urgent medical appointment without a parent or legal guardian or a signed consent, treatment will be denied.