The caregiver permission is good for up to 2 years.
Learn how to name a caregiver for your child and what form you’ll need to fill out.
- This page, Name a caregiver for your child, is offered by
- Probate and Family Court
- Massachusetts Court System
Name a caregiver for your child
Contacts
Probate and Family Court locations
The Details of Name a caregiver for your child
What you need for Name a caregiver for your child
A parent may give permission to someone their child lives with to make medical and educational decisions for the child, making them a caregiver. This process doesn't take away any of your rights to make decisions or child custody, but allows the caregiver to make educational and medical decisions without talking to you first. This is a much simpler process than guardianship, and no forms need to be filed in court.
To name a caregiver for a child, you and the caregiver must complete the Caregiver Authorization Affidavit.
Fees for Name a caregiver for your child
There may be a charge to have the form notarized.
How to request Name a caregiver for your child
The parent fills out the front page of the affidavit under the heading “Authorizing Party,” and the caregiver fills out the last paragraph on the back page called “Caregiver Acknowledgment.”
The parent must sign this form in front of 2 witnesses (who are not the caregiver) and a notary public. The witnesses and the notary sign on the back page. Notaries are often available at banks and courts. You can also find a notary in the yellow pages. Please note that you’ll need to show a picture I.D. to the notary. There may be a charge to have the form notarized.
Both the parent and the caregiver should carefully read the form before signing, since you’re swearing that the information in it is true.
Next steps for Name a caregiver for your child
Make copies of the form
The caregiver needs to give a copy of the form to the child’s school, doctor, and dentist. The caregiver should keep a list of everyone they gave the form to, in case they have to let them know about changes. The caregiver should make copies for themself and keep the original in a safe place.
More info for Name a caregiver for your child
If you and caregiver disagree on a decision, you make the final decision.
If you change your mind about the caregiver decision, you need to write a letter to the caregiver, saying that the caregiver no longer has permission to make these decisions. Please be sure to sign the letter and include the date. The parent and the caregiver each gives a copy of this letter to the child’s school, doctor, and dentist.
Downloads for Name a caregiver for your child
Open PDF file, 75.16 KB,
Caregiver Authorization Affidavit
(English, PDF 75.16 KB)
Open PDF file, 81.84 KB,
Instructions for the Massachusetts Caregiver Authorization Affidavit
(English, PDF 81.84 KB)