If a Tennessee parent signs a 'blanket consent' for a school or provider to treat a minor's physical ailments and administer medication, does that consent also waive the parental-consent requirement for psychological or counseling services?

Plain-English summary

Tennessee Code Annotated § 63-1-176 generally requires a parent's consent before a healthcare provider, government entity, or other person can do four things to a minor: treat physical ailments, prescribe medication, render psychological services, or render counseling services. The statute carves out exceptions, including when the parent has given "blanket consent" for "an activity" listed in the statute.

The question presented: if a parent signs a blanket consent that specifically references only physical-ailment treatment and medication administration, does that consent waive the parental-consent requirement for psychological and counseling services too?

The AG concluded that the answer is likely no. A blanket consent for one specific activity does not toggle off the entire parental-consent statute. The carveout's reference to "an activity" (singular, indefinite article) means the waiver covers only the specific activity the parent authorized. Psychological and counseling services still need their own consent.

What this means for you

If you are a school nurse or school counselor

This opinion tightens up what a generic permission slip covers. A start-of-year form authorizing "medical treatment and medication" is enough to cover routine first aid, an Advil dose, or a scraped-knee cleanup. It is not enough to cover sending the student to talk with the school counselor about a personal issue, or starting any kind of regular psychological or counseling service. For those, you need a separate, specific consent that names psychological or counseling services as the activity authorized.

Practical step: review your district's intake forms. If a single paragraph tries to cover physical care, medication, and counseling all at once, split it into clearly delineated sections, each separately initialed. That makes the scope of consent unambiguous and matches the AG's reading of "an activity."

If you are a pediatrician or primary care provider

Standard new-patient blanket consents are typically scoped to "general medical care," which the AG's analysis treats as covering only activities (1) and (2) under the statute. If your practice provides behavioral health services or refers internally to a psychologist or counselor, do not assume the original consent extends to those. Get a fresh consent specific to the psychological or counseling service, signed by the parent, before initiating it. The AG opinion expressly contemplates that parents will give "a single activity" worth of consent at a time.

If you operate a youth camp, residential program, or boarding facility

Your intake forms probably include a broad consent. Re-read it through the lens of this opinion. If the document says "I consent to medical treatment and medication," that does not cover counseling or psychological services your staff might offer. If it says "I consent to all health services," that broader formulation may cover more, but the AG's analysis of the singular indefinite "an activity" still suggests courts will read it narrowly. The safest design is parallel consents for each category in § 63-1-176(b).

If you are a parent

You retain meaningful control here. A consent form covering one type of treatment does not waive your consent rights over other types. If a school or program wants to provide psychological services or counseling, you should expect a separate, specific consent form. If they proceed without one, that is a violation of § 63-1-176(b), and the program's reliance on a generic form likely will not be a valid defense.

If you are an attorney advising a school district or healthcare practice

Treat this opinion as a cautious construction. The AG flagged that statutory interpretation could go either way and chose the narrower reading. A court applying the same statute could reach the same result. Audit your client's consent forms; recommend either a single specific-activity form per category in § 63-1-176(b), or a single consolidated form with separate initialing per category. Avoid omnibus "all health services" language that might be read as not specific enough to be a "blanket consent" at all.

Common questions

Q: What does "blanket consent" mean in this statute?
A: The AG defines it as "assent in all instances" for a single specified activity. So if a parent gives blanket consent for medication administration, the school can administer medications repeatedly across the school year without seeking re-consent each time. But the consent does not extend to psychological services even though both fall within § 63-1-176(b).

Q: Does this opinion say providers can never act without parental consent?
A: No. Section 63-1-176(c) lists six carveouts. Beyond blanket consent (carveout 1), the others cover (2) good-faith reliance on someone holding themselves out as the parent, (3) emergency medical/surgical treatment under § 63-6-222, (4) emergency medical services under § 68-140-309, (5) emergency care by law enforcement under § 63-6-218, and (6) bleeding control by school employees under § 49-2-137. Each of those can apply independently of any blanket consent.

Q: Is this opinion binding on Tennessee schools and providers?
A: AG opinions are persuasive but not binding. A court could read the statute differently. That said, the analysis is well-grounded and the AG flags the most natural reading of the text. Risk-aware schools and providers will follow it.

Q: What about consent for vaccines specifically?
A: Vaccination is a form of medication administration under § 63-1-176(b)(2). A blanket consent that specifically authorizes "vaccinations" or "medication administration" covers it. A blanket consent that does not mention medication does not.

Q: Can a parent rescind a blanket consent?
A: The opinion does not directly address rescission, but the temporal reading the AG adopts (consent applies "during the time that" it is in effect) supports the conclusion that a parent can withdraw consent. After withdrawal, the parental-consent requirement applies again to that activity.

Q: Does the McKinney-Vento Act override § 63-1-176 for homeless students?
A: McKinney-Vento changes how schools must handle enrollment and education, not what consents apply to medical or psychological treatment. A homeless student still has parental-consent protections under § 63-1-176 for the four listed activities.

Q: What if the parent disappears or is unavailable?
A: The statute lists carveout (2): a provider may rely in good faith on someone's representation that they are the parent or have authority to make decisions. That is the operative path when the actual parent is unreachable, so long as the representation is in good faith.

Background and statutory framework

Section 63-1-176, sometimes called the "Tennessee Parental Rights in Healthcare Act" in shorthand, codifies the principle that parents control medical, psychological, and counseling decisions for their minor children. Subsection (b) lists four covered activities; subsection (c) lists six carveouts.

The "blanket consent" carveout in § 63-1-176(c)(1) is what allows schools and providers to operate practically. Without it, a school nurse would need separate consent for every Advil dose and every scrape disinfected. With it, a parent can pre-authorize medication or routine treatment for the school year as a whole.

The statutory interpretation question is whether that carveout is written narrowly (one activity at a time) or broadly (any one consent toggles off the whole subsection). The AG opinion applies standard Tennessee statutory-construction principles: start with plain text, read terms in context, prefer the reading that avoids absurd results.

The "absurd-results" example the AG offers is illuminating. If a parent's blanket consent for emergency bleeding control under § 63-1-176(c)(6) toggled off the whole section, a school could later send the same student to a psychologist years later without parental consent, citing the original bleeding-control authorization. That cannot have been the legislature's intent. The same logic applies to a written blanket consent: it is best read as covering only the specific activity it authorizes.

Citations and references

Statutes:
- Tenn. Code Ann. § 63-1-176 (Parental consent for minor treatment)
- Tenn. Code Ann. § 63-22-122 (Counseling services)
- Tenn. Code Ann. § 49-2-137 (Bleeding control kits in schools)

Cases:
- Niz-Chavez v. Garland, 593 U.S. 155 (2021), singular indefinite article in statutory text
- State v. Perrier, 536 S.W.3d 388 (Tenn. 2017), courts avoid statutory constructions leading to absurd results
- Funk v. Scripps Media, Inc., 570 S.W.3d 205 (Tenn. 2019), Tennessee plain-language interpretation rule

Source

• Landing page: https://www.tn.gov/attorneygeneral/opinions.html
• Original PDF: https://www.tn.gov/content/dam/tn/attorneygeneral/documents/ops/2025/op25-005.pdf

Original opinion text

STATE OF TENNESSEE
OFFICE OF THE ATTORNEY GENERAL
February 21, 2025
Opinion No. 25-005
Interpretation of Tennessee Code Annotated § 63-1-176's "Blanket Consent" Provision

Question
In Tennessee, a person cannot provide a minor the medical interventions set out in Tenn.
Code Ann. § 63-1-176(b) without obtaining parental consent. But carveouts to that statutory
restriction exist. The question here relates to the scope of the "blanket consent" carveout in § 63-
1-176(c)(1). Does a "blanket consent" form signed by a parent that specifically references only
the treatment of physical ailments, § 63-1-176(b)(1), and the administration of drugs or
medications, § 63-1-176(b)(2), remove the parental consent requirement for all activities listed in
§ 63-1-176(b)?

Opinion
Likely not.

ANALYSIS

Tennessee Code Annotated § 63-1-176(b) states that "[e]xcept as otherwise provided by
statutory law, case law, or court order, a government entity, a healthcare provider, or any other
person shall not knowingly take any of the following actions with regard to a minor without first
obtaining" parental consent:

(1) Treat, profess to diagnose, operate on, or prescribe for any physical ailment,
physical injury, or deformity;
(2) Prescribe, dispense, deliver, or administer any drug or medication;
(3) Render psychological services specified in §§ 63-11-202 and 63-11-203; or
(4) Render counseling services specified in § 63-22-122.

The statute then provides that "[t]his section does not apply when":

(1) A parent of the minor has given blanket consent authorizing the person or entity
to perform an activity listed in subsection (b);
(2) A government entity, healthcare provider, or any other person reasonably relies
in good faith on an individual's representations that the individual is the parent of
a minor or has otherwise been granted authority to make decisions regarding a
minor's health care under state law;
(3) A licensed physician performs emergency medical or surgical treatment
pursuant to § 63-6-222;
(4) Licensed personnel render appropriate emergency medical care and provide
emergency medical services pursuant to § 68-140-309;
(5) A person, including a law enforcement officer, participates or assists in
rendering emergency care pursuant to § 63-6-218; or
(6) An employee of a local education agency acts to control bleeding using a
bleeding control kit pursuant to § 49-2-137.

Id. § 63-1-176(c). The question here is whether the "blanket consent" exemption to the parental-
consent requirement may be applied to particular categories of covered treatments or services (like
a consent applicable only to the treatment of physical ailments or administration of drugs or
medications), see 63-1-176(b)(1)-(2), or whether a "blanket consent" removes the parental consent
requirement for all activities listed in § 63-1-176(b).

The answer to this question turns on the proper interpretation of § 63-1-176(c). Under one
interpretation of that provision, a "blanket consent" for a particular "activity" listed in § 63-1-
176(b) constitutes an across-the-board authorization to perform that one intervention, and the
remaining interventions contained in the subsection still require separate parental consent. Under
another, a "blanket consent" for a particular "activity" listed in § 63-1-176(b) must authorize any
"activity" listed in that provision because the entire "section" does not apply. Applying statutory
interpretation principles, a court seems likely to adopt the first interpretation.

"[T]o determine what a statute means," Waldschmidt v. Reassure Am. Life Ins. Co., 271
S.W.3d 173, 175 (Tenn. 2008) (citing In re Audrey S., 182 S.W.3d 838, 869 (Tenn. Ct. App.
2005)), courts always "begin with the plain language of the statute," Funk v. Scripps Media, Inc.,
570 S.W.3d 205, 219 (Tenn. 2019) (citing Lee Med., Inc. v. Beecher, 312 S.W.3d 515, 526 (Tenn.
2010)). "[C]ourts must presume that a legislature says in a statute what it means and means in a
statute what it says there." Zedner v. United States, 547 U.S. 489, 510 (2006) (Scalia, J.,
concurring in part and concurring in the judgment) (quoting Conn. Nat'l Bank v. Germain, 503
U.S. 249, 253-54 (1992)). And "[a] statute must be construed as a whole." Ferrell v. Cigna Prop.
& Cas. Ins. Co., 33 S.W.3d 731, 738 n.3 (Tenn. 2000) (quoting State ex rel. McGhee v. St. John,
837 S.W.2d 596, 604 (Tenn. 1992)). "[A] particular section should not be read in isolation of the
remainder of the statute." Id.

We start by analyzing what it means to give "blanket consent" for "an activity." The term
"blanket consent" is not defined in § 63-1-176, or anywhere else in the Tennessee Code. When
a statutory term is undefined, courts often look to "authoritative dictionaries published around the
time of a statute's enactment." State v. Deberry, 651 S.W.3d 918, 925 (Tenn. 2022) (citing State
v. Edmondson, 231 S.W.3d 925, 928 n.3 (Tenn. 2007)). And they often "separate a phrase into its
'component terms' and then reconstruct it to determine its meaning." Jaeger v. Palladium
Holdings, LLC, 884 N.W.2d 601, 605 (Minn. 2016); see also Deberry, 651 S.W.3d at 927
(examining phrase in criminal statute by defining each term separately and then reconstructing it).
Splitting the phrase into its component parts, "blanket" means "[a]pplying to or covering all
conditions or instances," and "consent" means "[t]o give assent" or "agree." Am. Heritage
Dictionary of the Eng. Language, 193, 391 (5th ed. 2016). Thus, "blanket consent" is assent in all
instances. See Torrens v. Lockheed Martin Servs. Grp., Inc., 396 F.3d 468, 470 (1st Cir. 2005)
(discussing a Puerto Rican law that "granted blanket consent to any future acquisition by the
United States" of land in Puerto Rico for "naval, military or other public purposes").

"An activity," as used in the statute, refers to a single activity listed in § 63-1-176(b). "An"
is "[t]he form of a used before words beginning with a vowel sound," and "a" is an indefinite
article "[u]sed before nouns and noun phrases that denote a single but unspecified person or thing."
Am. Heritage Dictionary of the Eng. Language, 1, 63 (5th ed. 2016). Courts routinely derive
statutory meaning from the use of indefinite articles, such as "a" or "an." See, e.g., Niz-Chavez v.
Garland, 593 U.S. 155, 161-65 (2021); First Am. Nat'l Bank of Knoxville v. Olsen, 751 S.W.2d
417, 421 (Tenn. 1987). Here, "an" is modified by "activity listed in subsection (b)." Tenn. Code
Ann. § 63-1-176(c)(1). Thus, the phrase "an activity listed in subsection (b)" likely refers to a
single activity listed in § 63-1-176(b). See Niz-Chavez, 593 U.S. at 161 ("'a' notice" referred to
"'a' single document . . . not a mishmash of pieces with some assembly required").

Putting those phrases together, § 63-1-176(c)(1) refers to a situation in which a parent gives
a general authorization ("blanket consent") for a person to perform a single activity ("an activity")
listed in § 63-1-176(b) in all instances.

The question then becomes what effect a blanket consent has on the application of the
parental consent requirement in § 63-1-176(b) to other covered activities. When introducing the
carveouts, Tenn. Code Ann. § 63-1-176(c) states: "This section does not apply when . . . ." It has
been suggested that if a parent gives "blanket consent" for a person to perform one "activity" listed
in § 63-1-176(b) on their minor child, then the "section" as a whole does not apply. Id. § 63-1-
176(c). But the plain text and the surrounding provisions refute the notion that the "section" as a
whole permanently toggles on and off if a single carveout is satisfied at any point in time. Rather,
the text and statutory context indicate a temporal element to § 63-1-176(c) that requires courts to
analyze the carveouts' application individually and in particular factual scenarios.

This reading finds support in the statute's use of the term "when," which typically means
"at what time," "at the time that" or "as soon as." Am. Heritage Dictionary of the Eng. Language,
1971 (5th ed. 2016) (cleaned up); see also Merriam-Webster's Collegiate Dictionary, 1424 (11th
ed. 2007) (defining "when" as "at or during the time that" and "just at the moment that"). These
definitions support the application of a situational analysis by directing that application of the
parental-consent requirement will not apply to "an activity" "during the time that" a valid, blanket
consent regarding that activity is in effect.

The surrounding structure of the statute likewise supports that view. Tennessee Code
Annotated § 63-1-176(c) does not just create a carveout for blanket consents. It also, for example,
provides that "[t]his section does not apply when . . . [a]n employee of a local education agency
acts to control bleeding using a bleeding control kit" or when "[a] licensed physician performs
emergency medical or surgical treatment." Id. § 63-1-176(c)(3), (6). Neither of those time-limited
scenarios are amenable to waiving the parental-consent requirements across the board; instead,
they support the temporally limited, fact-specific application of the parental-consent requirement
to a given listed activity. Under the contrary reading, the provision of life-saving, emergency care
for a student's physical injury would mean that a local education agency could years later
"[r]ender" totally unrelated "psychological services" without parental consent because the
"section" as a whole no longer applied. Id. § 63-1-176(b)(4). The far more natural reading of the
law is that the section's parental-consent requirement is inapplicable to the act of controlling the
bleeding or performing emergency surgery, i.e., to the time-limited provision of care covered by
the exception, but would still be required before later psychological or counseling services could
be provided to that minor. Any other interpretation not only creates tension with the statutory text
and structure; it would lead to the absurd result of linking consent for entirely unrelated services
to the happenstance of an emergency. See State v. Perrier, 536 S.W.3d 388, 396 (Tenn. 2017)
("In construing statutes, Tennessee law provides that courts are to avoid a construction that leads
to absurd results.").

In short, the best reading of the statute at issue is that it contemplates a limited exemption
from the parental-consent requirement that applies "when" the facts at hand fall within a particular
carveout; applying one carveout does not trigger an across-the-board, permanent suspension of the
"section" entirely. As applied to Tenn. Code Ann. § 63-1-176(c)(1), that means a "blanket
consent" form that specifically references only § 63-1-176(b)(1) and (b)(2) likely does not remove
the parental-consent requirement for all activities listed in § 63-1-176(b). Instead, the "blanket
consent" likely only applies to the specific subsection(s) provided on the form.

JONATHAN SKRMETTI
Attorney General and Reporter

J. MATTHEW RICE
Solicitor General

JOSHUA D. MINCHIN
Assistant Solicitor General

Requested by:
The Honorable Esther Helton-Haynes
State Representative
425 Rep. John Lewis Way N.
Suite 502 Cordell Hull Building
Nashville, Tennessee 37243

The Honorable Todd Gardenhire
State Senator
425 Rep. John Lewis Way N.
Suite 716 Cordell Hull Building
Nashville, Tennessee 37243