2015 ORS 109.580¹
Relative caregiver affidavit

A relative caregiver affidavit given to a health care provider or school is invalid unless it is signed and contains, at a minimum, the following information:

(1) The name of the minor child;

(2) The minor child’s date of birth;

(3) The relative caregiver’s name and date of birth and the address at which the relative caregiver lives with the minor child;

(4) The relationship of the relative caregiver to the minor child;

(5) The Oregon driver license or identification card number of the relative caregiver;

(6) The contact information of the legal parent or guardian;

(7) A description of any attempts that the relative caregiver has made to advise the legal parent or guardian of the relative caregiver’s intent to consent to medical treatment or educational services for the minor child, and of any response to the relative caregiver provided by the legal parent or guardian;

(8) If applicable, the reason why the relative caregiver is unable to contact the legal parent or guardian to advise the legal parent or guardian of the relative caregiver’s intent to consent to medical treatment or educational services for the minor child;

(9) The date the relative caregiver signed the affidavit; and

(10) A declaration under penalty of perjury that the named minor child lives with the relative caregiver, that the relative caregiver is a competent adult and 18 years of age or older and that the information provided in the affidavit is true and correct. [2013 c.231 §4]

Note: See note under 109.570 (Legislative findings).

Chapter 109

Law Review Cita­tions

12 WLJ 569-589 (1976)


1 Legislative Counsel Committee, CHAPTER 109—Parent and Child Rights and Relationships, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors109.­html (2015) (last ac­cessed Jul. 16, 2016).
 
2 Legislative Counsel Committee, Annotations to the Oregon Revised Stat­utes, Cumulative Supplement - 2015, Chapter 109, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ano109.­html (2015) (last ac­cessed Jul. 16, 2016).
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.