A custody consent form is a consent agreement where the custody of a minor is agreed upon with the first party and the second party. The custody likewise means that the responsibility of the child shall be with the receiving party in ensuring the overall taking care of the child. However, in medical clinics, the care of the child shall require parents that the authority and care are given to the clinic throughout the period of care. This form is a simple web form that clinics can use for taking custody of the child from the parents. Using this form helps in making easier processes for custody procedures and ensuring the storage of information in a secured database.