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Relative Caregiver Affidavit

Missouri law provides that a relative caregiver may consent to the medical treatment provided for under section 431.061 RSMo and for educational services for a child that cannot otherwise legally consent to those services if a parent has delegated in writing the parent’s authority to consent to medical and educational services or, if after reasonable efforts to obtain the parent’s consent, the caregiver is unable to contact the parent.

The “Relative Caregiver Affidavit” form provided here meets the requirements set out in 431.058 RSMo. The Missouri Bar makes available as a public service the “Relative Caregiver Affidavit” for use by the general public. This form may be downloaded and/or photocopied as needed. There is no copyright on this form and it is provided for free.

Download the Relative Caregiver Affidavit Form

Missouri law requires that the affidavit must be completed and signed by the caregiver in front of a Notary Public. The affidavit may be provided to schools and/or medical providers when services for the child are sought and consented to by the relative caregiver. State law stipulates that the affidavit expires one year after the date it is given to the health care provider or school. State law also provides that the consent of a relative caregiver is superseded by any conflicting decision of a parent as long as the parent’s decision does not threaten the life, health or safety of the child. In addition, state law requires the relative caregiver to immediately notify any health care provider or school if the child stops living with them, making the affidavit invalid.

Please note that state law outlines that neither the affidavit or anything in this section of law relieves a parent of liability for payment for medical treatment or educational services provided to a child pursuant to the valid consent of a relative caregiver.

For more information, read the complete section of state law concerning relative caregivers here.

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