General Consent Forms
The General Consent for Treatment and Release of Information form is used to obtain authorization from and provide information to the patient or their representative.
Available languages
INFORMATION FOR MINORS OR ADULTS PRESENTING FOR CARE WITHOUT THEIR PARENT OR LEGAL GUARDIAN:
If you are unable to bring your minor or adult with legal guardian to an appointment, ensure that a note authored by you is provided and has the following information:
- The date of service
- Name of adult individual bringing the patient to the appointment
- Patient name
- Patient date of birth
- Explanation or clear purpose for the visit
- Signature of parent or legal guardian
This note must be provided to the front desk.
Corewell Health offers a template that can be filled out and brought to the appointment, instead of drafting your own note. Visit note: Authorization to Treat and For Another to be Present During the Appointment.
Note: If a note is provided, you may still be contacted by a clinical team member during the patient’s appointment.