Parental notification and consent is required for a minor to receive general health services until the minor has reached the age of majority, unless this age is modified by law that changes the age of consent.  Washington State's general age of majority for health care decisions is 18 years of age.  A minor may be considered an adult for legal purposes before reaching 18 years of age if the minor is legally emancipated or if the minor is married to an adult.

Washington has established a lower age of consent by law for certain specific health services.  The age of consent for testing for sexually transmitted diseases is 14, for inpatient or outpatient mental health treatment is 13, and for outpatient substance use disorder treatment is 13.  Minors may consent to reproductive health services in Washington, including birth control, abortion, and prenatal care, at any age.

Informed consent for health care on behalf of a patient who is under the age of majority and who is not otherwise authorized to provide informed consent may be obtained from a school nurse, school counselor, or homeless student liaison when:

• the minor patient meets the definition of a homeless child or youth under the federal McKinney-Vento homeless education assistance improvements act of 2001;
• the minor patient is not under the supervision or control of a parent, custodian, or legal guardian, and is not in the care and custody of the Department of Social and Health Services; and
• consent is necessary for non-emergency, outpatient, primary care services, including physical examinations, vision examinations and eyeglasses, dental examinations, hearing examinations and hearing aids, immunizations, treatments for illnesses and conditions, and routine follow-up care customarily provided by a health care provider in an outpatient setting, excluding elective surgeries.

An unaccompanied homeless youth who is a minor patient who is not otherwise authorized to provide informed consent and is unable to obtain informed consent from a school nurse, school counselor, or homeless student liaison is authorized to provide informed consent for non-emergency, outpatient, primary care services, including:

• physical examinations,
• vision examinations and eyeglasses,
• dental examinations,
• hearing examinations and hearing aids,
• immunizations,
• treatments for illnesses and conditions, and
• routine follow-up care customarily provided by a health care provider in an outpatient setting, excluding elective surgeries. 

"Youth" and "minor" mean an unemancipated individual who is under the chronological age of 18 years.  "Unaccompanied" means a youth experiencing homelessness while not in the physical custody of a parent or guardian.  "Homeless" means without a fixed, regular, and adequate nighttime residence as set forth in the federal McKinney-Vento act of 2001.

A health care provider may, but is not required to, request documentation that the minor patient is an unaccompanied homeless youth.  Acceptable documentation includes, but is not limited to, a written, oral, or electronic statement by:

• staff at a governmental or nonprofit human services agency or homeless services agency;
• an attorney representing the minor; or
• an adult relative of the minor or other adult with knowledge of the minor and the minor's housing situation.

A health care facility or a health care provider is not subject to administrative sanctions or civil liability for providing health care services in good faith based upon the consent of the unaccompanied homeless youth minor on the minor's own behalf or upon the documentation.

A person who provides a statement for documentation that the minor patient is an unaccompanied homeless youth is not subject to administrative sanctions or civil liability for providing documentation in good faith based upon the person's knowledge of the minor patient and the minor patient's housing situation.