Oct282025
Guardianship Q&A Series

How can I ensure I can still attend medical or school appointments after my child turns eighteen? – North Carolina

Short Answer

In North Carolina, the simplest way is to have your 18-year-old sign consent-based documents that let you participate: a Health Care Power of Attorney, HIPAA authorizations with each provider, and FERPA releases with the school. If your child cannot reliably give informed consent, you can ask the Clerk of Superior Court for a limited guardianship tailored to health care and/or education, which preserves other rights whenever possible.

Understanding the Problem

When a child turns 18 in North Carolina, they become the legal decision-maker for health care and education. Parents often ask: can I keep attending medical and school appointments, speaking with providers, and helping with forms? Here, the parent wants a less restrictive way to stay involved because the child (who has autism) struggles with finances, processing information, and self-advocacy.

Apply the Law

North Carolina law favors the least restrictive option that still protects the adult. That means using consent-based tools first (your child authorizes your access), and turning to guardianship only if needed. If guardianship is necessary, the Clerk of Superior Court can tailor a limited guardianship to just the areas where help is needed (for example, medical decisions), and the court must preserve rights the person can still exercise. To obtain a guardianship, a petitioner must prove incompetence by clear, cogent, and convincing evidence. The proceeding happens before the Clerk of Superior Court in the county with jurisdiction, and the respondent has robust notice and hearing rights.

Key Requirements

  • Use consent-based tools first: Have the adult child sign a Health Care Power of Attorney, HIPAA releases with each provider, and FERPA releases with the school so you can attend and receive information.
  • Capacity is required to sign: Your child must understand what they’re signing; if capacity is doubtful, consider limited guardianship.
  • Limited guardianship is narrowly tailored: The Clerk can grant authority only over health care and/or education while leaving other rights (like managing simple personal matters) intact.
  • High proof standard for guardianship: The petitioner must prove incompetence by clear, cogent, and convincing evidence; the respondent can have counsel and request a jury.
  • Forum and timing: File in the Clerk of Superior Court; after filing, hearings are scheduled promptly by the clerk, and service on the respondent is typically by the sheriff.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Because your child can process information with support but struggles with self-advocacy, start with consent-based tools: have your child sign a Health Care Power of Attorney naming you as agent, plus HIPAA releases for each provider and FERPA releases with the school. If your child cannot reliably understand or maintain these authorizations, ask the Clerk for a limited guardianship focused on health care (and education if needed) so you can attend appointments and communicate with providers, while preserving other rights.

Process & Timing

  1. Who files: For consent tools, your adult child signs provider and school forms; for a Health Care Power of Attorney, your child signs before proper witnesses/notary. For guardianship, a parent or any interested person files. Where: Consent forms are executed with providers/schools; guardianship is filed with the Clerk of Superior Court in the proper North Carolina county. What: Guardianship uses AOC-SP-200 (Petition) and AOC-SP-201 (Notice of Hearing). When: Execute consent forms ideally before the 18th birthday to avoid any gap; if filing guardianship, the clerk sets a hearing promptly after filing and service.
  2. After filing guardianship, the sheriff typically serves the respondent; the Clerk schedules the hearing. The respondent may request a jury and may be appointed a guardian ad litem; some counties request a capacity questionnaire to help tailor limited orders.
  3. At the hearing, if the high proof standard is met, the Clerk enters a limited guardianship order confined to health/education as needed and issues Letters of Appointment so you can act. If capacity exists, rely on the signed HIPAA/FERPA releases and the Health Care Power of Attorney to attend and receive information.

Exceptions & Pitfalls

  • If your child lacks capacity to understand and sign a Power of Attorney or releases, those documents may be invalid—pursue limited guardianship instead.
  • Releases can be revoked by your adult child; providers and schools may require their own forms even if you bring a general release.
  • Mental health records and services can have added consent rules; some providers require specific mental health releases under state law.
  • Overbroad guardianship can unnecessarily restrict rights; request a limited guardianship tailored only to health care and/or education.
  • Service and notice are formal in guardianship cases; missing service requirements can delay your hearing.

Conclusion

To keep attending medical and school appointments after your child turns 18 in North Carolina, use consent-based tools first: have your child sign a Health Care Power of Attorney, HIPAA releases, and FERPA releases so you can communicate and attend. If your child cannot give reliable consent, seek a limited guardianship through the Clerk of Superior Court narrowly confined to health and/or education. Next step: gather provider and school release forms and complete a Health Care Power of Attorney before the 18th birthday.

Talk to a Guardianship Attorney

If you’re dealing with how to stay involved in your adult child’s medical and school decisions, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

Category: Guardianship Q&A Series

Author: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.