Use this form to choose another person to care for your child when you cannot. This is called a "person in parental relationship." For example, if you are detained by Immigration and Customs Enforcement (ICE) or you are too sick to care for your child. This form does not change your rights and you can cancel it any time. This option gives more limited powers than "standby guardianship" and does not require going to court.
The person you choose must agree to take care of your child. They will be able to talk to your child's school, teachers and doctors. They can make basic decisions about your children's health care. But they can not agree to surgery or other major medical procedures for your child. And they do not have to financially support your child.
When will this go into effect?
In Question 4 on the form, you choose when you want the permission to go into effect. It can start:
- right away,
- on a specific date in the future, or
- if a particular event happens, for example if you are detained by Immigration and Customs Enforcement (ICE).
How long is it good for?
You can choose if you want the form to last for a year or less in Question 4 on the form.
Can I put any limits on this person's ability to make decisions?
This form is for routine decisions about the child's healthcare and education. If you want to put limits on what the person can decide about your child's healthcare and schooling, cross out and put your initials next to items in Question 5 on the form.
What if I have shared custody of my child?
If there is a Court order for both parents to agree on decisions about the child's education or health, then both parents must sign the form. If not, only one parent must sign.
Filling out the form
Complete the form linked below to name a person in parental relationship for your child. You can fill out one form for all your children. Or you can fill out separate forms for each child. If possible, you both sign the form in front of a notary.
Last Reviewed: August 5, 2024