The Consent To Treat Minor Form is a critical document in Indonesian healthcare settings where medical treatment needs to be administered to individuals under the age of 21 (the age of majority in Indonesia). This document becomes necessary when minors require medical attention in situations where parents or legal guardians may not be immediately present to provide direct consent. It complies with Indonesian healthcare legislation, including Law No. 36 of 2009 on Health and related regulations. The form typically includes detailed patient information, scope of authorized treatments, emergency provisions, and necessary declarations. It serves as a legal safeguard for healthcare providers while ensuring minors can receive prompt medical attention when needed, particularly in school settings, sports facilities, or during temporary guardianship situations.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Your data doesn't train Genie's AI
You keep IP ownership of your docs
1. Patient Information: Details of the minor patient including full name, date of birth, address, and any relevant identification numbers
2. Parent/Legal Guardian Information: Complete details of the parent(s) or legal guardian(s) providing consent, including their relationship to the minor
3. Healthcare Provider Information: Details of the healthcare facility and/or specific healthcare providers authorized to provide treatment
4. Scope of Consent: Clear description of the medical treatments, procedures, and services being authorized
5. Duration of Authorization: Specification of the time period for which the consent remains valid
6. Emergency Authorization: Specific authorization for emergency medical treatment when parent/guardian cannot be immediately reached
7. Financial Responsibility: Statement acknowledging responsibility for payment of medical services
8. Declarations and Signatures: Formal declarations of understanding and agreement, with spaces for dated signatures of all parties
1. Specific Medical Conditions: Section for listing any pre-existing conditions, allergies, or specific medical concerns - used when the minor has known medical issues
2. Medication Authorization: Specific authorization for administration of certain medications - used when regular medication might be needed
3. Religious or Cultural Preferences: Section specifying any religious or cultural considerations affecting treatment - used when family has specific religious/cultural requirements
4. Alternative Contact Information: Additional emergency contacts - used when parents/guardians want to designate other trusted adults
5. Transportation Authorization: Permission for medical transport - used when treatment might require transfer between facilities
1. Medical History Form: Detailed medical history of the minor including vaccinations, previous conditions, and family medical history
2. List of Current Medications: Complete list of any current medications, dosages, and administration schedules
3. Insurance Information: Details of medical insurance coverage and policy information
4. Emergency Contact List: Comprehensive list of emergency contacts in order of priority
Find the exact document you need
Informed Consent And Health Declaration Form
An Indonesian-law compliant combined informed consent and health declaration document for medical procedures and treatments, meeting national healthcare regulatory requirements.
Download
Informed Consent Form
Indonesian-compliant Informed Consent Form for medical procedures or research participation, meeting local healthcare regulations and patient rights requirements.
Download
Beauty Consent Form
An Indonesian-law compliant consent form for beauty treatments and procedures, ensuring informed client consent and legal protection for service providers.
Download
Aesthetic Consent Form
An Indonesian-compliant informed consent form for aesthetic procedures, meeting local healthcare regulations and protecting both provider and patient interests.
Download
Iv Consent Form
An Indonesian-compliant informed consent form for IV procedures, meeting local healthcare regulations and ensuring documented patient consent.
Download
Consent Document
An Indonesian law-compliant consent document for personal data collection and processing under the PDP Law.
Download
Patient Consent Form For Treatment
An Indonesian-compliant medical consent form documenting patient authorization for treatment, aligned with local healthcare regulations.
Download
Travel Permission Letter For Minor
An Indonesian legal document authorizing minor travel, compliant with national child protection and immigration laws.
Download
Consent Permission Letter
An Indonesian law-compliant formal letter documenting explicit authorization from one party to another, establishing legal consent for specific actions or purposes.
Download
Certificate Of Consent Form
An Indonesian law-compliant document that formally records and validates explicit consent for specific activities or procedures.
Download
Permission Letter From Parents
An Indonesian law-compliant document where parents/guardians authorize specific activities or services for their minor child.
Download
Employee Media Release Form
An Indonesian law-compliant consent form authorizing employer use of employee media content, including images and recordings, for company purposes.
Download
Photo Authorization Form
An Indonesian law-compliant authorization form for photographic usage rights, ensuring proper consent and data protection under local regulations.
Download
Waxing Consent Form
An Indonesian-compliant consent form for waxing services that documents client approval and understanding of the procedure, risks, and aftercare requirements.
Download
Sports Consent Form
An Indonesian-compliant consent form for sports participation that covers risk acknowledgment, medical declarations, and liability releases under Indonesian sports law.
Download
Reference Consent Form
An Indonesian-law compliant consent form authorizing the release of employment references, aligned with local PDP and employment regulations.
Download
Participant Consent Form
An Indonesian-compliant legal document for obtaining informed consent from research participants, adhering to local data protection and research regulations.
Download
Nail Consent Form
An Indonesian-compliant consent form for nail treatments, documenting client approval and treatment details while meeting local health and safety regulations.
Download
Data Privacy Consent Form
An Indonesian law-compliant Data Privacy Consent Form for obtaining explicit consent for personal data processing under UU PDP requirements.
Download
Consent Declaration Form
An Indonesian law-compliant consent declaration form for personal data collection and processing under the PDP Law.
Download
Video Consent And Release Form
An Indonesian law-compliant consent form for video recording and usage rights, protecting both content creators and participants under local data protection regulations.
Download
Statement Of Consent
An Indonesian law-compliant document recording explicit permission for specific actions or data processing, governed by the Civil Code and Personal Data Protection Law.
Download
Social Media Consent Form
An Indonesian law-compliant consent form for social media content usage and personal data processing, aligned with PDP Law requirements.
Download
Personal Information Consent Form
An Indonesian law-compliant consent form for personal data collection and processing under the PDP Law, ensuring legal data handling and subject rights protection.
Download
Permission To Treat Form
An Indonesian-compliant medical consent form documenting patient authorization for healthcare treatment, aligned with local health regulations and patient rights requirements.
Download
Parental Consent Letter
An Indonesian law-compliant document allowing parents/guardians to authorize specific permissions regarding their minor child.
Download
Parent Consent Form For Work
An Indonesian legal document providing parental/guardian authorization for minor employment, ensuring compliance with national labor laws and child protection regulations.
Download
Mutual Consent Agreement
An Indonesian law-governed agreement documenting mutual understanding and consent between parties, establishing agreed terms and conditions.
Download
Media Permission Form
An Indonesian-compliant legal document granting permission for media content usage, subject to Indonesian copyright and data protection laws.
Download
Letter Of Consent Form
An Indonesian-law governed document that formally captures explicit permission or authorization from an individual or entity for specific actions or uses, ensuring compliance with local consent and data protection regulations.
Download
Generic Consent Form
An Indonesian law-compliant consent form template for documenting explicit permission from individuals, adhering to PDP Law requirements.
Download
Employee Consent Letter
An Indonesian-law governed document obtaining explicit employee consent for specific workplace actions or data usage, complying with local labor and data protection laws.
Download
Consent And Indemnity Form
An Indonesian law-governed document combining explicit consent provisions with indemnification terms to manage risk and liability between parties.
Download
Massage Consent Form
An Indonesian-compliant consent form for massage services that documents client approval, health information, and data privacy agreements under local healthcare regulations.
Download
Consent Letter For Rent Agreement
An Indonesian law-compliant formal letter providing authorized consent for rental arrangements, incorporating local property regulations and civil code requirements.
Download
Consent For Surgery Form
An Indonesian-compliant surgical consent form documenting patient authorization and understanding of proposed surgical procedures, risks, and benefits.
Download
Filming Permission Form
An Indonesian law-governed permission form authorizing filming activities at specific locations, establishing terms and conditions for film production while ensuring regulatory compliance.
Download
Consent For Access To Information Form
An Indonesian law-compliant consent form for authorized access to personal information, aligned with the PDP Law requirements.
Download
Spa Consent Form
An Indonesian-law compliant spa consent form capturing client information, medical history, and treatment authorizations while ensuring regulatory compliance with local spa service requirements.
Download
Photography Consent And Release Form
An Indonesian law-compliant consent and release form for photography services, protecting both photographer and subject rights under local data protection and copyright laws.
Download
Genie’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; Genie’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it
.png)
.png)