Minor Patient Consent Policy

MINOR PATIENT CONSENT POLICY

Direct Pay Virtual Clinic

SECTION 1: DEFINITIONS

•       "Minor" means any individual under the age of eighteen (18) years.

•       "Parent" means a biological parent, adoptive parent, or stepparent with legal custody.

•       "Legal Guardian" means a person appointed by a court to make healthcare decisions on behalf of a minor.

•       "Authorized Representative" means a parent, legal guardian, or other person with legal authority to consent on behalf of a minor patient.

•       "Emancipated Minor" means a minor legally emancipated by court order, marriage, or active military service, who may consent to their own healthcare as an adult.

•       "Minor-Consented Services" means the specific categories of healthcare for which Minnesota law permits a minor to consent independently, described in Section 3.

SECTION 2: GENERAL RULE — PARENTAL OR GUARDIAN CONSENT REQUIRED

2.1 Default Consent Requirement

As a general rule, a parent or legal guardian must provide informed consent before Direct Pay Virtual Clinic provides any healthcare service to a minor patient. This applies to all telehealth consultations, prescriptions, lab orders, imaging orders, and referrals, unless a specific exception applies under Minnesota law as described in Section 3.

This is consistent with Minn. Stat. § 144.341 and HIPAA’s personal representative provisions (45 C.F.R. § 164.502(g)), which recognize parents and legal guardians as personal representatives of minor patients.

2.2 Who May Consent on Behalf of a Minor

The following individuals may provide consent for a minor patient, subject to verification:

•       A biological or adoptive parent with legal custody

•       A stepparent with legal custody

•       A court-appointed legal guardian with authority over healthcare decisions

•       A person standing in loco parentis granted authority by a parent or court

•       An emancipated minor, who consents on their own behalf

Documentation of legal authority may be required at the Clinic’s discretion. In disputed custody situations, written documentation will be requested before services are provided.

2.3 Consent Process for Minor Patients

1.     The authorized representative must be present at the start of the telehealth session to provide verbal consent and confirm their identity and relationship to the minor.

2.     The authorized representative must sign all applicable intake and consent documents on behalf of the minor.

3.     The minor patient should be present during the clinical portion of the visit. The authorized representative may remain present at the Provider’s discretion and consistent with the minor’s privacy rights.

4.     The Provider may, at their discretion, speak privately with the minor to ensure open communication about sensitive topics.

2.4 Telehealth-Specific Considerations

•       The authorized representative must ensure the minor has a functioning device, camera, microphone, and stable internet connection

•       The authorized representative is responsible for ensuring the minor is in a safe, private location during the visit

•       The authorized representative accepts responsibility for following up on all treatment recommendations, prescriptions, lab orders, and referrals

•       The authorized representative must be reachable during the appointment in case the Provider needs to consult with them

SECTION 3: EXCEPTIONS — WHEN A MINOR MAY CONSENT INDEPENDENTLY

3.1 Legal Basis

Minnesota law (Minn. Stat. §§ 144.341–144.347) grants minors the independent right to consent to certain categories of healthcare without parental knowledge or consent. These provisions recognize that requiring parental consent in certain sensitive situations may deter minors from seeking necessary care.

When a minor consents under these exceptions, records related to those services are generally not accessible to parents without the minor’s authorization, consistent with HIPAA (45 C.F.R. § 164.502(g)(3)) and Minn. Stat. § 144.293.

3.2 Categories of Services for Which a Minor May Consent Independently

 

Category	Statute	Key Provisions
STI Testing, Diagnosis & Treatment	Minn. Stat. § 144.343, Subd. 1	Any minor may consent to examination, testing, and treatment for sexually transmitted infections. No parental consent or notification required.
Pregnancy-Related Care	Minn. Stat. § 144.343, Subd. 1	A minor who is or believes they may be pregnant may consent to pregnancy-related healthcare including prenatal care.
Contraception	Minn. Stat. § 144.343, Subd. 1	A minor may consent to contraceptive counseling and prescription contraceptives without parental consent.
Outpatient Mental Health Services	Minn. Stat. § 144.341, Subd. 2	A minor age 16 or older may consent to outpatient mental health treatment without parental consent. The Provider may notify parents if clinically necessary and not harmful to the minor.
Alcohol & Drug Abuse Treatment	Minn. Stat. § 144.341, Subd. 2; § 253B.04	A minor may consent to outpatient alcohol and drug abuse counseling and treatment. Federal law (42 C.F.R. Part 2) provides additional confidentiality protections for substance use disorder records.
Emergency Care	Minn. Stat. § 144.344	Emergency care may be provided without parental consent when delay would endanger the minor’s life or health and a parent cannot be reached promptly.
Emancipated Minor — All Services	Minn. Stat. § 144.341, Subd. 1	An emancipated minor has full legal capacity to consent to all healthcare services as an adult. Documentation of emancipation is required.
Minor Living Apart & Self-Supporting	Minn. Stat. § 144.341, Subd. 1	A minor living apart from parents and managing their own finances may consent to general healthcare. Assessed case-by-case.

 

3.3 Limitations on Minor Consent Exceptions

•       Exceptions apply only to the specific category of service. Parental consent is still required for any services outside that category provided during the same encounter.

•       The Provider retains professional discretion to involve a parent or guardian when clinically necessary to protect the minor’s health or safety, provided such disclosure is not otherwise prohibited by law.

•       The Clinic will not provide services under a minor consent exception if the minor lacks capacity to understand and consent to the services being provided.

•       Minor consent exceptions do not override mandatory reporting obligations under Minnesota law — see Section 6.

SECTION 4: PRIVACY AND CONFIDENTIALITY OF MINOR PATIENTS

4.1 General Privacy Protections

All health information relating to minor patients is PHI under HIPAA (45 C.F.R. Parts 160–164) and the Minnesota Health Records Act (Minn. Stat. Ch. 144). The Clinic maintains confidentiality of all minor patient health information and will not disclose it without appropriate authorization, except as permitted or required by law.

4.2 Parental Access — General Rule

As a general rule, parents and legal guardians are treated as personal representatives under HIPAA (45 C.F.R. § 164.502(g)) and may access their minor child’s health records, authorize disclosures, and exercise other patient rights on behalf of the minor.

4.3 Exceptions to Parental Access — Minor-Consented Services

When a minor has independently consented to services under Section 3.2, the health records related to those services are generally confidential from parents, consistent with:

•       HIPAA (45 C.F.R. § 164.502(g)(3)) — which limits parental access where the minor consented to the care

•       Minn. Stat. § 144.293, Subd. 2 — which restricts disclosure without patient authorization

•       42 C.F.R. Part 2 — which provides heightened confidentiality for substance use disorder treatment records, including those of minors

Practically: if a minor independently consents to STI testing, pregnancy care, contraception, or substance use counseling, those records will not be shared with parents without the minor’s authorization, unless otherwise required by law.

4.4 Additional Parental Access Restrictions

The Clinic may restrict parental access to a minor’s records where:

•       The Provider has reasonable grounds to believe providing access could endanger the minor (e.g., suspected abuse)

•       The Provider determines, in professional judgment, that restricting access is in the minor’s best clinical interest

•       Applicable law otherwise requires or permits restriction

4.5 Separated or Divorced Parents

The Clinic will generally provide health information to both parents unless presented with a court order restricting one parent’s access. The Clinic is not responsible for determining or enforcing custody arrangements beyond reviewing documentation presented to us.

4.6 Minor Patient Privacy During the Telehealth Visit

The Provider may speak privately with a minor patient during a portion of a telehealth visit involving sensitive health topics, to ensure the minor feels comfortable disclosing relevant information. The authorized representative will be informed of this practice and may be asked to briefly leave the video session during this portion of the visit.

SECTION 5: PRESCRIBING TO MINOR PATIENTS

5.1 General Prescribing Rules

All prescribing to minor patients is subject to the Clinic’s Prescription Policy Agreement. Parental consent is required before prescriptions are issued to a minor patient, except for services in the Section 3.2 categories. Direct Pay Virtual Clinic does not prescribe controlled substances via telehealth to any patient, including minors.

5.2 Medication Monitoring for Minor Patients

Authorized representatives are responsible for: administering medications to minors who cannot self-administer; monitoring for side effects and adverse reactions; storing medications safely and out of reach of children; and scheduling follow-up appointments for refills and monitoring as recommended by the Provider.

SECTION 6: MANDATORY REPORTING OBLIGATIONS

6.1 Mandated Reporter Status

The Provider is a mandated reporter under Minnesota law. Licensed healthcare professionals are required by Minn. Stat. § 626.556 (child abuse) and Minn. Stat. § 626.557 (vulnerable adult abuse) to report suspected maltreatment to appropriate authorities. These obligations apply regardless of any confidentiality protections, including minor consent exceptions and HIPAA.

6.2 Child Abuse and Neglect Reporting

If the Provider has reasonable cause to believe a minor patient has experienced physical abuse, sexual abuse, emotional abuse, neglect, or other maltreatment, the Provider is legally required to report to:

•       The local child protection agency (county social services), or

•       Local law enforcement (police or sheriff’s department)

Reports may be made without prior notice to the parent, guardian, or patient. Failure to make a required report is a misdemeanor under Minnesota law.

6.3 Communicable Disease Reporting

Certain communicable diseases diagnosed in minor patients are subject to mandatory reporting to the Minnesota Department of Health under Minn. Stat. § 144.4804 and Minnesota Rules Ch. 4605, regardless of whether the minor independently consented to testing or treatment. Reportable conditions include certain STIs, tuberculosis, hepatitis, HIV, and others designated as reportable under state rules.

6.4 Duty to Protect

If a minor patient discloses intent to harm themselves or others during a telehealth visit, the Provider has a duty to take appropriate protective action, which may include involving parents or guardians, contacting emergency services, or arranging emergency psychiatric evaluation. This duty applies regardless of confidentiality protections otherwise applicable to the minor’s health information.

SECTION 7: TELEHEALTH-SPECIFIC REQUIREMENTS FOR MINOR PATIENTS

7.1 Required Presence of Authorized Representative

For all appointments where parental consent is required (all services outside Section 3.2 exceptions), the authorized representative must be physically present with the minor or visible on the video call at the start of the appointment to provide consent. If the authorized representative cannot be present or reached, the appointment will be rescheduled.

Exception: For minor patients consenting to their own care under a Section 3.2 exception who are of sufficient age and maturity, the authorized representative’s presence is not required for that visit. The Provider will assess the minor’s capacity to participate independently.

7.2 Geographic Requirement

All minor patients must be physically located within the State of Minnesota at the time of their telehealth visit, consistent with the Clinic’s licensure requirements. The authorized representative is responsible for confirming the minor’s location at scheduling and at the time of the visit.

7.3 Emergency Protocol for Minor Patients

If a medical emergency arises during a minor patient’s telehealth visit, the Provider will advise the authorized representative or the minor (if attending independently) to call 911 immediately. For mental health crises, the Provider will advise calling 988 (Suicide and Crisis Lifeline) or taking the minor to the nearest emergency room, as clinically appropriate.

SECTION 8: REQUIRED CONSENT FORMS AND DOCUMENTATION

The following documents must be completed for minor patients receiving care at Direct Pay Virtual Clinic:

 

Document	Who Signs	Required For
This Minor Patient Consent Policy	Authorized representative	All minor patients
Telehealth Informed Consent Form	Authorized representative; minor may co-sign if age-appropriate	All minor patients
Patient Rights and Responsibilities	Authorized representative	All minor patients
Financial Policy and Payment Agreement	Authorized representative	All minor patients
Prescription Policy Agreement	Authorized representative; minor signs if self-consenting	If prescriptions anticipated
HIPAA Authorization Form	Minor (if self-consenting) OR authorized representative	For record releases only
Documentation of Legal Authority	Provided by authorized representative	If non-parent guardian or contested custody

SECTION 9: AUTHORIZED REPRESENTATIVE ACKNOWLEDGMENT AND CONSENT

By signing below, the authorized representative acknowledges and agrees that:

5.     They have read, understand, and agree to this Minor Patient Consent Policy in its entirety;

6.     They are the lawful parent, legal guardian, or authorized representative of the minor patient identified below, with legal authority to consent to healthcare services on the minor’s behalf;

7.     They understand the general rule that parental consent is required for most healthcare services and the specific exceptions under Section 3 where the minor may consent independently;

8.     They understand that health records related to services for which the minor independently consented may be confidential from them under applicable law;

9.     They accept responsibility for following up on all treatment recommendations, prescriptions, lab orders, and referrals issued during the minor’s visits;

10.   They understand the Clinic’s mandatory reporting obligations and acknowledge that the Provider will make required reports to authorities as required by law;

11.   They have been given the opportunity to ask questions about this policy and have had them answered to their satisfaction.

 

 

Minor Patient Full Name		Date of Birth
Minor Patient Age		Allergies
Reason for Visit		Current Medications

 

Representative Full Name		Relationship to Minor
Representative Phone		Representative Email
Legal Authority	☐ Biological/Adoptive Parent     ☐ Stepparent with Custody     ☐ Court-Appointed Legal Guardian     ☐ Emancipated Minor (self)     ☐ In Loco Parentis     ☐ Other: _______________
Custody Documentation	☐ Not applicable     ☐ Attached     ☐ On file with Clinic     ☐ Will provide upon request

 

Authorized Representative Full Legal Name (Print): _______________________________   Date of Birth: _______________

Authorized Representative Signature: _______________________________   Date Signed: ___________________

 

If the minor patient is consenting to their own care under a Minnesota law exception (Section 3.2) and is of sufficient age and maturity, the minor may also sign below:

Minor Patient Full Name (Print): ____________________________________________   Age: _______________

Minor Patient Signature: __________________________________________________   Date Signed: ___________________

Category of Minor-Consented Service (from Section 3.2): _____________________________________________

 

 

FOR CLINIC USE ONLY

Document Provided By		Date Provided
Authority Verified By		Documentation on File
Consent Type	☐ Parental/Guardian Consent     ☐ Minor Self-Consent (Section 3.2 exception — category): ___________________________
Mandatory Report Filed		Report Filed With