Tennessee In Loco Parentis Medical Consent: The 60-Day Healthcare Affidavit

The child living with you needs to see a doctor, and the parent who signed the Power of Attorney is temporarily unreachable — in surgery, traveling internationally, or between phones. Tennessee provides a backup instrument for exactly this situation: the in loco parentis healthcare affidavit under T.C.A. § 34-6-401 through § 34-6-406.

It is narrower than a POA, shorter-lived, and has specific rules about who can use it.

What This Affidavit Does

The in loco parentis affidavit lets an adult relative who is already caring for a child authorize medical, dental and mental health care when the parent, guardian or POA holder is not reasonably available. The relative executes a sworn affidavit under penalty of perjury directly at the health care facility.

Unlike the T.C.A. § 34-6-301 Power of Attorney, this affidavit does not require the parent's signature. The relative signs it on their own authority as someone standing in loco parentis — in the place of the parent.

The Priority Order

Not just any adult can sign. T.C.A. § 34-6-402 establishes a priority order:

1. Noncustodial parent
2. Grandparent
3. Adult sibling (of the child)
4. Stepparent
5. Other adult relative

A grandparent can execute the affidavit only if the noncustodial parent is also unavailable. An aunt or uncle falls under "other adult relative" and is fifth in priority.

In practice, when a child is living with a grandparent and both parents are unreachable, the grandparent is the natural signer.

The 60-Day Limit

This is the critical difference from a POA. The affidavit is valid for only 60 days from execution. It can be renewed once for an additional 60-day period — giving a maximum window of 120 days.

After 120 days, if the parent still has not returned or become available to execute a formal POA, you are operating without statutory medical consent authority. At that point, obtaining a court order or a signed POA becomes urgent.

What It Covers and What It Does Not

The affidavit covers medical, dental and mental health care decisions. It does not cover school enrollment, educational records access, or everyday caregiving authority — those require a T.C.A. § 34-6-301 POA.

Under T.C.A. § 34-6-403(b)(6), the in loco parentis affidavit specifically cannot authorize consent to abortion, sterilization, psychosurgery, long-term mental health facility commitment, or mental health treatment for minors 16 and older (which falls under the minor's own consent rights at T.C.A. § 33-8-202).

Third-Party Protections

Health care providers who rely on the affidavit in good faith are protected under T.C.A. § 34-6-406 — no civil liability, no criminal liability, no administrative discipline. This protection mirrors the third-party immunity for the POA.

When to Use the Affidavit vs. a POA

Use the POA when the parent is available and willing to sign. The POA is broader (school + medical + daily life), lasts until the child turns 18, and gives you a permanent document to keep on file.

Use the in loco parentis affidavit as an emergency bridge — the parent is temporarily unavailable, the child needs care now, and you have no other legal authority.

If you anticipate needing both school and medical authority on an ongoing basis, the Tennessee School and Medical Consent Guide covers both instruments and explains when each one applies.

See more Tennessee guides →