Kentucky Caregiver Authorization Affidavit: What It Is and How to Complete It

When you're suddenly raising a grandchild, niece, or nephew in Kentucky and the child needs to see a doctor or start school, you'll hear about the Caregiver Authorization Affidavit. It's the document that gives you legal authority to make medical and school decisions without going to court — and if you're a relative caregiver, it may be the only paperwork you need.

What the Caregiver Authorization Affidavit Actually Does

Kentucky created this affidavit through Senate Bill 176 in 2014, codified under KRS 405.024 (health care treatment and school-related decisions) and KRS 158.144 (school-related decisions). It lets an adult caregiver who has a child living in their home sign a sworn statement — under penalty of perjury — authorizing them to:

• Enroll the child in public school and make school-related decisions
• Consent to the health care treatment defined in KRS 405.024(1)(f), subject to the statute's exclusions
• Approve immunizations, developmental screenings, and mental health evaluations
• Sign school permission slips, field trip forms, and extracurricular paperwork

The affidavit does not give you legal custody. It does not change child support obligations. It does not make you the child's guardian. It's an administrative tool that bridges the gap between a family crisis and the child's day-to-day needs.

Who Qualifies to Sign

You must be at least 18 years old and the child must currently live in your home. Kentucky defines a caregiver as an adult person with whom a minor resides, including a grandparent, stepgrandparent, stepparent, aunt, uncle, or any other adult relative. The affidavit requires you to state your relationship to the child.

The statutory definition begins with an adult person with whom the minor resides and lists relatives as examples. A Power of Attorney under KRS 403.352 is another option when a parent or legal guardian chooses to delegate parental rights.

What the Affidavit Must Include

KRS 405.024(2) spells out the required content. Every affidavit needs:

• Your full legal name, home address, and a statement that you are over 18
• The child's full legal name and date of birth
• A statement that the child lives in your home
• Your specific relationship to the child (grandmother, uncle, etc.)
• The names of the child's parents, de facto custodian, guardian, or legal custodian
• A statement authorizing you to consent to healthcare and make school decisions
• Dated signatures from the child's parent, de facto custodian, guardian, or legal custodian approving the arrangement — or a statement describing the circumstances of any required signer's unavailability and your reasonable efforts to locate them
• A mandatory notice that knowingly making a false statement is a Class A misdemeanor
• A statement confirming the affidavit does not grant custody or de facto custodian status

The completed affidavit must be signed by you under penalty of perjury and acknowledged before a commissioned notary public. Call your county clerk to ask whether it offers notary service for this affidavit.

What Happens If a Parent Objects

A contrary decision by a parent, de facto custodian, guardian, or legal custodian supersedes yours under KRS 405.024(6). A parent, de facto custodian, guardian, legal custodian, or caregiver may revoke the affidavit; it is also revoked if the child stops living with you. Give written notice to schools and health care providers that have the affidavit on file.

This is by design. The affidavit doesn't change anyone's parental rights — it gives you enough authority to handle the child's daily needs when the parent cannot.

Where to Get the Form

Model templates are available free from Kentucky Youth Advocates and the Kinship Families Coalition of Kentucky. The Kentucky Legislative Research Commission publishes the full statutory text online. If you want a detailed walkthrough with preparation checklists and troubleshooting guides, our School and Medical Consent for Grandparents and Relatives in Kentucky toolkit covers the entire process from first signature through annual renewal.

The One-Year Clock

Every caregiver affidavit expires one year from the date you sign it. Kentucky allows annual renewal — you execute a fresh affidavit each year. Mark the date on your calendar, because an expired affidavit won't be accepted at a school office or doctor's appointment.

If you're caring for the child long-term, consider whether formal guardianship through District Court might make more sense than renewing an affidavit every twelve months. Our Kentucky school and medical consent guide includes a decision framework for knowing when court involvement becomes the better path.

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