Who should a chiropractic clinic text when the patient is a child?

Text the parent or guardian who consented to the care, not the child, keep every message generic, and know that HIPAA treats the parent as the child's personal representative in most cases, with exceptions and state law limits. GoHighLevel can keep one parent record with a record for each child. The bottom line: a family account is a records problem first and a messaging problem second, and the messaging goes wrong when the system cannot tell which person it is writing about.

What HIPAA says about parents and minors

According to HHS guidance, a parent, guardian, or person acting in loco parentis with legal authority to make health care decisions for an unemancipated minor is generally the child's personal representative and is treated as the individual for most purposes under the Privacy Rule. HHS describes three exceptions: when the minor consents to a service and no other consent is required by law, when someone other than the parent is authorized by law to consent, and when the parent agrees to a confidential relationship between the provider and the child. HHS adds that the Privacy Rule defers to state or other applicable law on disclosure to a parent, and its FAQ on notices says that in the limited cases where the parent is not the personal representative, the clinic must give its notice to the minor. The practical point is that your family records need to say who the representative is.

How a family account should be set up

A family with three children and one phone number is the same record problem we describe in our guide on sending reminders for each pet when one owner has three animals, and the same custom object approach works here: the child is an object associated with the parent's contact.

What the text says

Because the text goes to the parent, it can name the child by first name when that helps, but it still should not mention a condition or a treatment. Sample: Hi Dana, this is [Clinic]. A reminder that Mia has a visit tomorrow at 4:00. Reply C to confirm or call [number]. Reply STOP to stop messages. If the family has two children with appointments on the same day, list both in one message to avoid a text for each.

Build it in HighLevel

1. Create a Child custom object with fields for first name, birth month and year, and the next appointment date.
2. Associate each child with the parent contact, and keep the parent's mobile number as the contact's phone.
3. Add a Guardian authority field to the parent contact, and record the basis for treating them as the representative if it is not a parent.
4. Build reminder workflows from the child record's appointment date, using the custom object workflow trigger, and send the message to the parent.
5. Combine same day appointments for siblings with an If/Else that checks for another child's appointment on the date.
6. Add a consent field for the parent and make the reminder workflows skip any contact without it.
7. For teenagers, ask the clinic's counsel how your state treats a minor's own consent and what the family should be told.

A confirmation rule

Ask the parent to confirm the child's name and date of birth in the new patient form, and ask for a second contact for emergencies. If a different adult will bring the child, record that adult's name and ask the parent to approve it before the visit. A clear record prevents the common mistake of telling the wrong person about a visit.

Worked example

A clinic with 80 child patients from 50 families sends reminders to 50 parents instead of 80 numbers (80 children, 50 families). If 20 of the families have two children and book the same day, a combined message saves 20 texts a month. The family counts are assumptions, so replace them with your own.

When the parents are separated

Separated or divorced parents can disagree about who should receive messages and who may consent to care. The clinic's record should say who has legal authority to make health care decisions, based on the documents the family provides, and only that person should receive reminders. If there is a dispute, ask counsel before sending anything to a second parent. HHS ties the personal representative role to legal authority, not to who brings the child.

Teenage patients

A teenager may have views about who receives messages. Ask the parent and the teen at intake how they want reminders handled, and record the answer. State law decides when a minor may consent to care alone, and HHS says the Privacy Rule defers to state law on disclosures to parents, so ask counsel how your state applies the rules to chiropractic care before building a separate path for teens.

How this was handled before

The front desk wrote the parent's number on each child's chart, and reminders went out one per child. A parent with three children received three messages for three visits on the same afternoon. A family record makes one message do the work.

What to measure

Track families with a complete record, reminders sent per family, combined messages, and reminders sent to the wrong person. The wrong person count should be zero.

Questions people ask

Who should a clinic text when the patient is a minor?

Generally the parent or guardian who consented to care, since HHS treats the parent as the child's personal representative in most cases, subject to exceptions and state law.

Can the text name the child?

It can use the child's first name when it helps the parent, but it should not mention a condition or a treatment.

What if a teenager consents to care alone?

HHS lists exceptions to the parent's role as representative, and state law governs. Ask your counsel how your state applies them.

You can start a GoHighLevel account here and build the family records, and see custom objects and workflows in our capabilities demo.