Authorization for Release of Health Information

To Download the Release form, Click Here or on the image below

Eaton Rapids Medical Center Release Form

Consent for a Minor to Receive Treatment

Leaving Town?

You can make sure your child has quick access to medical treatment by signing a Minor Consent Form. If your child needs care while you are away, this form will save valuable time in tracking down a parent/guardian to obtain permission for treatment.

Please know that if your child's injuries or illness is life-threatening, Eaton Rapids Medical Center may begin treatment prior to your approval.

To Download the Consent form, Click Here or on the image below

Eaton Rapids Medical Center Consent Form for Minors

Authorization for Proxy Access to Patient Portal

To Download the Release form, Click Here or on the image below

Eaton Rapids Medical Center Release Form