The Caregiver Affidavit serves as a crucial legal tool when parents need to temporarily delegate caregiving authority to another person, such as a relative or trusted friend. This document is particularly important in situations where parents are temporarily unable to care for their children due to military deployment, illness, work obligations, or other circumstances. While requirements vary by state, the affidavit typically includes detailed information about all parties involved, specific authorities granted, and duration of the arrangement. Unlike guardianship, this document does not terminate parental rights and can be revoked by the parents. The document must comply with both federal regulations (such as HIPAA and FERPA) and state-specific requirements.
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1. Declaration and Identification: Caregiver's personal information and relationship to child
2. Child Information: Child's full name, date of birth, and current address
3. Parent/Guardian Information: Parents' or legal guardians' details and contact information
4. Scope of Authority: Specific powers granted to caregiver including medical, educational, and daily care decisions
5. Duration: Time period for which the affidavit is valid
6. Attestation: Sworn statement of truth and accuracy of information provided
1. Medical Authorization: Detailed authorization for medical decision-making, including emergency care, routine checkups, and medication administration
2. Educational Authorization: Specific powers related to school enrollment, access to records, and educational decision-making
3. Travel Authorization: Authorization for in-state, interstate, or international travel with the child
4. Financial Responsibility: Statement regarding financial obligations and responsibilities for child's care
1. Schedule A - Medical History: Detailed medical history including conditions, allergies, medications, and immunization records
2. Schedule B - Emergency Contacts: Comprehensive list of emergency contacts including backup caregivers and medical providers
3. Schedule C - Supporting Documentation: Copies of identification documents, relevant court orders, or prior agreements
4. Schedule D - State-Specific Requirements: Additional forms or documentation required by specific state laws
Affiant
Caregiver
Child
Legal Guardian
Parent
Minor
Custodial Rights
Medical Care
Educational Decisions
Emergency Care
Authorization Period
Residence
Primary Care Provider
School District
Healthcare Provider
Emergency Contact
Notary Public
State of Jurisdiction
Effective Date
Termination Date
Revocation
Medical Treatment
Educational Records
Medical Records
Legal Authority
Declaration and Authority
Grant of Powers
Duration and Termination
Medical Authorization
Educational Authorization
Emergency Care
Information Access
Travel Authorization
Residency
Revocation Rights
Liability and Indemnification
Privacy and Confidentiality
Governing Law
Severability
Attestation
Verification
Notifications
Document Custody
Modification Rights
Relationship of Parties
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