Accesa Health Forms

Parents / Legal Guardians:
Please download and complete this form to authorize a representative to consent for the treatment/service to be administered to your child (under age 18):

Authorization To Treat A Minor

LA County Hospital Form:
Please download and complete this form if you are a Non-County Employee or student who will be working in an LA County hospital. Save time by filling out your personal information and dates once. The summary instructions will make it easier for you to complete all of the information and get the signatures that you need. Feel free to share this link:

LA County Hospital Form