This form is to be completed for minor patients (under age 18) who need a parent or legal guardian to have a caregiver’s license. Up to two parents/legal guardians may apply for a caregiver’s license for the minor. This form is required for caregivers to complete their online license application. In order to obtain a caregiver license, the caregiver must complete a caregiver license application and be approved for a license. Only minor patients who have a physician certification of their medical need for a caregiver may have a licensed caregiver; the status of the applicant as a minor alone does not qualify the applicant for a caregiver.