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In the wake of the UFI Daily story regarding the State of Washington and the mother who lamented the fact that her high-school age daughter was given an abortion without her knowledge, I went to the Ballard High School website (Seattle, Washington) to take a look at their parental consent form.  You should take a look at it too; it’s included below.  I’ve also marked in red some points you might want to look at closely.  I suspect that versions of this form might be sitting in your child’s school office.

Every parent needs to read carefully any form that comes from your child’s school.  Most of us assume that a consent form like this is simply a way to have our child receive basic medical care and to have our child treated in the case of an emergency.  We all must understand that there are forces at work in your school, lobbying groups who have sway with your school administrators and teachers.  These group’s agendas might not necessarily line up with your ethics and values.  They are counting on you to not pay close attention.  Hopefully, your school’s form is a basic medical consent form, but you need to find out.

·         Please be aware that a mention of “reproductive health care” on any form or document opens the door to contraception, morning-after-pills, and abortion.

·         Note that on this form the decision to inform the parents is arbitrary.

·         Note that the “Center and its staff” are now in charge of all medical decisions regarding your child and that the child or the school does not have to notify you, the parent, of any issues regarding pregnancy, STDs, or drug use.

This situation brings to light many disturbing questions as to the State of Washington’s laws regarding parental rights.  I urge those of you in Washington State to look into the references in this form regarding what is “legally required.”

This situation should serve as a “wake-up call” for parents everywhere.  We all ought to be asking ourselves:  “What rights did I unknowingly sign away?”    And, vigilance is required to keep these types of situations out of our schools.


School-Based Health Centers Consent for Health Services

School-Based Health Centers located in Seattle Public Schools must have a signed consent from a parent or legal guardian before providing services to youth, except in situations where federal and/or state laws allow youth to access such treatment without parent/guardian consent.  Youth may independently access reproductive health care at any age; they may independently receive drug and alcohol services and mental health counseling from age thirteen.  If necessary, the Centers will inform youth of options for outside care and will assist the youth in discussing these issues with parents/guardians. If the youth is enrolled in school but is not enrolled in a School-Based Health Center, he/she can continue to receive school nurse services.

I hereby request and authorize that:

Print Youth’s Name:  ________________________________________________       _______________

First Name        Middle Initial              Last Name                                         Birthdate

receive any and all health care services available from and deemed necessary by the staff of the SBHC.  These services may include, but are not limited to, such procedures as well-teen care, evaluation and treatment of acute illness and injuries, immunizations, blood studies, photographs and X-rays.  Consent is also given for referral of care and if needed, emergency transportation, to other physicians, health care professionals, hospitals, clinics, or health care agencies as deemed necessary by the Center and its staff. This authorization does not allow services to be rendered without the youth’s consent, unless she/he is unable to consent.

When consent is provided for care, all information is kept confidential except in the following circumstances:

  1. The client gives permission through a signed release of information.
  2. If he/she indicates risk of imminent harm to self or others.
  3. He/she has a life threatening health problem and is under 18 years old.
  4. There is reason to suspect abuse or neglect.
  5. Certain communicable diseases must be reported to public health authorities.

I understand the youth’s consent is legally required for release of information about the following kinds of diagnoses and treatment: pregnancy, sexually transmitted diseases (including HIV/AIDS testing), and alcohol and drug or mental health counseling.

I have received a copy of the Swedish Medical Center’s Notice of Health Information Practices, which provides information about how the student’s health information may be used and disclosed.

The School-Based Health Center encourages each youth to involve his/her parents or guardians in health care decisions whenever possible.

Consent for services is authorized for the length of time the youth is enrolled in a school with a SBHC.  I may choose to withdraw the consent at any time by writing to the Center that serves the youth.

Youth Signature: _______________________________________________Date: ____________

Parent/Guardian Signature: _______________________________________Date: ____________

Name/Relationship of Legally  Responsible Guardian (Print):______________________________

Parent/Guardian Address:_________________________________________________________

Telephone: (_____)__________________ Work Telephone: (______)_______________________

Revised 7/16/03 Please complete both sides

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