Oregon Statutes 109.580 – Relative caregiver affidavit
A relative caregiver affidavit given to a health care provider or school is invalid unless it is signed and contains, at a minimum, the following information:
Terms Used In Oregon Statutes 109.580
- Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
(1) The name of the minor child;
(2) The minor child’s date of birth;
(3) The relative caregiver’s name and date of birth and the address at which the relative caregiver lives with the minor child;
(4) The relationship of the relative caregiver to the minor child;
(5) The Oregon driver license or identification card number of the relative caregiver;
(6) The contact information of the legal parent or guardian;
(7) A description of any attempts that the relative caregiver has made to advise the legal parent or guardian of the relative caregiver’s intent to consent to medical treatment or educational services for the minor child, and of any response to the relative caregiver provided by the legal parent or guardian;
(8) If applicable, the reason why the relative caregiver is unable to contact the legal parent or guardian to advise the legal parent or guardian of the relative caregiver’s intent to consent to medical treatment or educational services for the minor child;
(9) The date the relative caregiver signed the affidavit; and
(10) A declaration under penalty of perjury that the named minor child lives with the relative caregiver, that the relative caregiver is a competent adult and 18 years of age or older and that the information provided in the affidavit is true and correct. [2013 c.231 § 4]
See note under 109.570.
[Formerly 109.105; 1977 c.303 § 1; 2012 c.26 § 5; 2015 c.736 § 48; 2019 c.456 1,1a; repealed by 2023 c.228 § 52]
[Formerly 109.115; repealed by 1973 c.827 § 83]
[1971 c.726 § 1; 1973 c.454 § 1; repealed by 1973 c.827 § 83]
RIGHTS OF MINORS