Need a Form for Health Services?

Required For ALL Appointments:

Other Forms:

Caregivers Authorization Affidavit – Instructions

A Caregiver’s Authorization Affidavit is provided because of California’s recognition that adults who have minors living with them are “caregivers,” who often want and need to take some responsibility for the minor’s education and medical care.

A relative who has signed a Caregiver’s Authorization Affidavit may enroll a child in public school, make school-related medical decisions, and make other important decisions on the minor’s behalf. Non-relatives may also use this form to enroll a child in school and to receive school related medical treatment.

According to California law, schools and medical care providers must accept this form if it completed correctly. It is important to note that only the caregiver is required to sign the form, not the minor’s parents. 

Required Steps for the Caregiver
  • Complete the Caregiver's Authorization Affidavit form (see link above on this page)
  • Provide copy of caregiver's California driver's license
  • Caregiver must sign the form and have it notarized before submitting it
Back to Top