The Consent To Treat Minor Without Parent Form is a critical document in Canadian healthcare settings where minors may need to receive medical treatment without a parent or guardian present. This document becomes necessary in various situations, such as when parents are temporarily unavailable, in school or sports contexts, or when dealing with mature minors who have demonstrated capacity to make their own medical decisions. The form typically includes comprehensive patient information, medical history, emergency contacts, and specific treatment authorizations. It must comply with provincial healthcare consent laws, privacy legislation, and the mature minor doctrine established in Canadian case law. This document helps healthcare providers balance their legal obligations with the practical need to provide timely medical care to minors, while ensuring appropriate documentation and risk management.

1. Minor's Information: Full legal name, date of birth, address, and contact information of the minor

2. Parent/Guardian Information: Full details of parent(s)/legal guardian(s) including contact information and relationship to minor

3. Authorization Statement: Clear statement authorizing medical treatment without parent/guardian presence

4. Scope of Treatment: Specific types of medical care and procedures authorized

5. Emergency Contact Information: Alternative emergency contacts and their relationship to minor

6. Medical History Summary: Brief medical history including allergies, current medications, and significant conditions

7. Duration of Authorization: Time period for which the authorization is valid

8. Capacity Declaration: Statement confirming minor's capacity to understand and consent to treatment

9. Signature Block: Spaces for signatures of minor, witness, and healthcare provider