AUTHORIZATION TO CONSENT TO TREATMENT OF A MINOR
In the event that (I/we) cannot be reached to give (my/our) consent, (I/we) the undersigned parent(s)/legal guardian(s) of a minor, hereby authorize Cottey College and/or its agents to consent for (me/us) to any x-ray, examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care deemed necessary or advisable by a licensed physician during the period (my/our) child is registered for an overnight visit at Cottey College.
It is understood that this authorization is given in advance of any special diagnosis, treatment, or hospital care being required, but is given to provide authority and power on the part of Cottey College to give specific consent to the diagnosis, treatment, or hospital care which in the best judgment of a licensed physician, is deemed advisable.
It is further understood that provisions of this agreement are to be used only in the event of a medical emergency to preserve the immediate well being of the named student. Any and all expenses incurred as a result of use of these provisions will be the responsibility of the undersigned individual(s).