Temporary Guardianship

First step is to call Maura Merlis from the Office of General Council (OCG). Her number is 301-496-6043.  She will ask a few questions to assess the situation.  (Is this a new or existing patient? How come the parents or legal guardians are unable to accompany the patient? What does the visit involve? -such as consents, admission).

She will then let you know if this is the appropriate situation for the use of this form. If so, have the parents fill it out.  The original goes to Medical Records. The parents should get a copy as well as the person who has been granted temporary guardianship. The dates on the form should be the dates of the visit.

Note: A new form needs to be completed for every visit, even if it is the same person who is coming at a different time.  Also, if there will be consenting done at the visit, the parent or legal guardian is always the one who makes that decision. For example, my patient will be having scans done. Mom will be contacted via telephone to give consent to the contrast. The temporary guardian will sign on her behalf.

Temporary Decision Maker Form

Temporary Decision Maker Form-Best Practices