Doctor Refusing to Treat Your Grandchild Without Custody in New Hampshire

When the Clinic Says No

You've brought your grandchild to the pediatrician for a checkup, a vaccination, or a follow-up visit, and the front desk tells you they can't treat the child because you're not the parent or legal guardian. It's one of the most frustrating experiences a kinship caregiver faces — the child needs care, you're the adult responsible, and the system won't cooperate.

Here's how to handle it.

Why Providers Refuse

Under RSA 463:12, a guardian of a minor's person has the powers and responsibilities of a parent regarding the child's care and may give necessary consent for medical or other professional care. A parent or guardian may also appoint a temporary agent under RSA 461-A:19-a, subject to that statute's requirements. Without one of these forms of authority, a clinic may ask you for parent or guardian authorization, and its accepted paperwork can vary.

Immediate Steps at the Clinic

1. Ask if the care is urgent or emergency. If the child may have a medical emergency, call 911 or go to a hospital emergency department. EMTALA requires a Medicare-participating hospital ED to screen for an emergency medical condition and, if one is found, offer stabilizing treatment or an appropriate transfer. This federal requirement applies to hospital emergency departments; it does not require every clinic to provide routine care without guardian consent.

2. Ask for the patient advocate or office manager. Front-desk staff follow standard intake procedures. Ask whether the patient advocate or office manager can review non-standard consent instruments — parental delegation letters or temporary-agent appointments. Escalating past the front desk often resolves the issue.

3. Present your documentation. Bring whatever authority documents you have:

• A valid temporary agent appointment under RSA 461-A:19-a — the strongest non-court instrument, subject to the statute's limits
• A notarized parental delegation letter specifying medical consent authority
• A court order appointing you guardian under RSA 463

If you have none of these, ask the clinic whether they have their own provider-specific authorization form that the parent can complete remotely — some practices accept phone or fax authorization for routine visits.

4. Ask about proxy portal access. For ongoing care, request "Proxy Portal Access" through the healthcare system's health information management department. This gives you access to schedule appointments, view records, and manage the child's care within that system. It requires the parent or a legal custodian to authorize it — but once set up, it simplifies every future visit.

If the Provider Still Refuses

When a clinic won't budge on routine (non-emergency) care:

• Try a different provider. Acceptance of non-court consent instruments varies between practices. A community health center may be more flexible than a large hospital system.
• Contact the parent for a same-day authorization. Even a faxed or emailed signed consent may satisfy the provider for that visit.
• File for guardianship. If this is happening repeatedly — the parent is unreachable and providers keep refusing — a court-appointed guardianship under RSA 463 can provide ongoing consent authority if the court grants the petition. While a relative's guardianship petition is pending, the child may attend school in the relative's district under RSA 193:12.
• Seek an ex parte order. If the child needs care urgently but does not meet the emergency threshold, an ex parte guardianship order under RSA 463:7 may provide temporary authority if the court finds the statutory harm standard is met. For self-represented e-filings, the Judicial Branch says you must go to the courthouse within 5 business days or the petition is not considered filed; an order usually follows on the filing day or next business day after judicial review.

What to Say to the Provider

Keep it factual and calm:

"I'm this child's grandmother/relative. I've been raising them since [timeframe]. The child's parent is [unavailable/in treatment/incarcerated/unable to be reached]. Here is my [temporary agent appointment/delegation letter/guardianship petition]. I'm asking you to provide routine care consistent with this documentation. If you need additional authorization, please tell me specifically what you require and I'll work to provide it."

Document every refusal in writing — the date, the provider's name, what was refused, and the stated reason. This record supports a guardianship petition if you need to show the court that non-court instruments aren't sufficient for the child's ongoing care.

Be Prepared Before the Appointment

Our New Hampshire School and Medical Consent Guide includes a medical intake worksheet and an escalation protocol specifically for healthcare refusals. Having your documents organized, the right statutory references at hand, and a clear escalation path planned makes the difference between a wasted appointment and a child who gets care.

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