Form Aoc 796 PDF Details

The AOC-796 form, titled "Standard Power of Attorney for Medical/School Decision Making," plays a crucial role within the Commonwealth of Kentucky's Court of Justice framework, reflecting the state's commitment to providing a structured legal tool for the empowerment of individuals in making pivotal decisions regarding a minor's healthcare and education. This document meticulously outlines the process by which a resident of Kentucky may delegate the responsibility of making medical and school-related decisions for a minor child—to whom they are a biological parent, legal custodian, or guardian—to another trusted adult. The form intricately describes the types of medical treatments covered under the power of attorney, emphasizing a comprehensive approach that includes diagnostic procedures, treatments, hospitalizations, and preventive care, while explicitly excluding matters that require separate legal permissions such as HIV/AIDS and controlled substance testing. Furthermore, it addresses the educational facets, granting the attorney-in-fact the authority to make decisions concerning the child’s schooling. By requiring notarization, the document underscores its legitimacy and enforces its serious nature, also cautioning against the falsification of information which is considered a criminal offense. The legitimacy of the power granted through this form persists from its execution until explicitly terminated by the grantor in writing, indicating both flexibility and control in the hands of the parent or legal guardian. Notably, it clarifies that possession of this form does not imply lawful custody or guardianship of the child, setting boundaries for its application solely to medical and educational decisions and not altering the child's legal standing.

QuestionAnswer
Form NameForm Aoc 796
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesKRS, i796, 27A, ratifying

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AOC-796

Rev. 2-08

Page 1 of 1 Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 27A.095

STANDARD POWER OF ATTORNEY FOR MEDICAL/SCHOOL DECISION MAKING

KNOW ALL PERSONS BY THESE PRESENTS:

That I, ___________________________________, a resident of __________________(city) ______________(county)

__________(state) residing at ___________________________________(street address) do hereby make, constitute,

and appoint _______________________________, residing at __________________________________________(full

address) my true and lawful attorney in fact for me and in my name, place and stead, in their sole discretion, to transact, handle and dispose of the limited matters set forth herein, specifically:

To consent to medical treatment for __________________________, minor child, of whom I am the biological parent,

legal custodian or legal guardian. Medical treatment means any medical, chiropractic, optometric, or dental examination, diagnostic procedure, and treatment, including but not limited to hospitalization, developmental screening, mental health screening and treatment, preventive care, pharmacy services, immunizations recommended by the federal Centers for Disease Control and Prevention’s Advisory Committee on Immunization practices, well-child care, and blood testing, except that “medical treatment” shall not include HIV/AIDS testing, controlled substance testing, or any other testing for which a separate court order or informed consent is required under other applicable law.

To make school-related decisions for _______________________, minor child, of whom I am the biological parent, legal

custodian or legal guardian. I hereby affirm that the minor child resides with ___________________________________

(attorney in fact) at _____________________________________________________________________ (full address).

This instrument is intended to, and does hereby, grant to my attorney full power and authority to do and perform each and every act and thing whatsoever requisite, necessary and proper to be done, in the exercise of the rights and powers herein granted, as fully, to all intents and purposes, as I might or could do personally present, hereby ratifying and confirming all that my attorney shall do or cause to be done by virtue thereof.

It is fully understood that any school district asked to recognize the authority assigned by this instrument may regularly review and/or audit the residency of the child. Falsification of this document may constitute a criminal offense.

The rights, powers and authority of my attorney shall commence upon execution of this instrument and shall remain in full force and effect until this instrument is terminated by me in writing.

So acknowledged this _______ day of ____________________, 2________.

____________________________________

 

______________________________________

 

Parent/Legal Guardian’s Name (printed)

Parent/Legal Guardian’s Signature

Subscribed and sworn before me on_______________, 2_______.

__________________________________________, Notary Public. My commission expires: ___________,2_____.

THIS IS NOT A COURT ORDER.

The execution or possession of this form does not signify that a person has lawful custody or guardianship of the child mentioned herein. The limited purpose of this form is to indicate that the above-named person given power of attorney has the authority to consent to medical treatment and to make school-related decisions for the above-named child. This form is not required to be filed with the circuit court clerk. Falsification of this document may constitute a criminal offense.

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2. The third part would be to complete these fields: force and effect until this, So acknowledged this day of, ParentLegal Guardians Name printed, ParentLegal Guardians Signature, Subscribed and sworn before me on, Notary Public My commission, THIS IS NOT A COURT ORDER, The execution or possession of, mentioned herein The limited, the authority to consent to, and not required to be filed with the.

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