Cargiver Authorization Affidavit {PR-4}

PR-4 - CAREGIVER'S AUTHORIZATION AFFIDAVIT. This form is used in California to allow a caregiver to authorize school enrollment and medical care for a minor who resides in their home. This affidavit may be completed by an adult caregiver who is at least 18 years old and is responsible for the child’s day-to-day care. By completing the required sections, the caregiver can authorize school-related medical care, and if additional conditions are met, broader medical and dental care. The form requires basic identifying information about the minor and caregiver, along with statements regarding parental notification or inability to contact the child’s legal guardians. The affidavit must be signed under penalty of perjury and does not require notarization to be valid for most purposes. www.FormsWorkflow.com