When a client reaches adulthood, the parent or guardian who booked, paid and signed in for them may no longer have a right to their information. Coming of Age lists those clients and lets you decide, one at a time, what the parent keeps. Nothing happens on its own.
Open the list
Go to Patients → Coming of Age (the left nav label follows your practice type, for example Clients). The page lists clients who:
- turn 18 (or the age your age rules give them) in the next 90 days, or
- already came of age in the last three years and still have a parent or guardian linked: portal access, a parent or guardian as guarantor, a parent contact, or a child's place in a household.
Each row shows the client's name (click it to open the chart), when they turn or turned the age and why that age applies (set for this client, a state rule such as NE rule, or your practice's age), and who is linked, for example "Parent or guardian: Dana Ruiz (portal access, pays the bills, gets reminders)".
| Status | What it means | Button |
|---|---|---|
| Already of age | They passed the age and a parent is still linked | Decide |
| Release signed | The client signed the release you sent | Finish |
| Review due | You chose Parent keeps their part and the review date is within 30 days | Decide |
| Coming up | They come of age within 90 days | Decide |
| Release sent | The release is waiting in the client's portal | Open |
Clients without a date of birth, inactive clients and discharged clients are not listed. Locations connected to athenahealth do not use the list, since athena keeps those clients' details.
Decide what happens
Click Decide. The dialog shows when they come of age, who is linked, and whether the client has their own email and phone. Pick one path:
- Parent keeps their part. For a dependent adult or a legal guardianship. Nothing changes. Choose Look at it again on (a year from today by default, any future date); the client comes back to the list as Review due 30 days before it.
- Adulthood comes at another age. Where the client lives sets a different age. Enter it (14 to 25). The client leaves the list and comes back as that age nears.
- Client signs a release. The client chooses what their parent may still take part in. See Send a release.
- Client takes over. The parent's portal access ends at once. Ticked by default: Stop reminder copies to parents (turns off reminders for contacts listed as a parent or guardian) and Ask the client to confirm their own phone and email in the portal. Tick The client pays their own bills (remove the guarantor) to take the parent off billing; see Guarantors.
Add a Note (why, or what was agreed) if you like, then click Save. The confirmation lists what was done, for example "parent portal access ended (1); reminder copies to parents stopped (2)". Each decision is recorded in the HIPAA Audit Log.
Add the client's own email and phone
A release is signed in the client's own Client Portal, which signs them in by email. When you choose Client signs a release or Client takes over and the client has no email or phone of their own, the dialog shows The client's own contact details (not a parent's) with Client's email and Client's phone (optional). They only fill fields that are blank. An email or phone another client already uses is refused, because each client needs their own to sign in.
Send a release
- Choose Client signs a release.
- Pick the Release form. The list shows your consent forms, and one with "release" in its name is picked for you. If you have none, click Add the starter release form: it adds "Release of Information: Parent or Guardian", where the client ticks what their parent may take part in (scheduling, billing and payments, information about their care) and signs. Review its wording before you send it.
- Pause the parent's portal access until it's signed is ticked by default. Tick Also text the client the portal link to send a text as well as the email.
- Click Save. The row shows Release sent.
When the client signs, the row shows Release signed. Click Finish: the dialog shows what they agreed to, with three boxes set from their answers: Give back the parent's portal access, Stop reminder copies to parents and The client pays their own bills (remove the guarantor). Check them and click Finish release. Portal access comes back only for parents with an email on file.
Other buttons while a release is open:
- Done, keep access paused closes the decision without giving access back (for a release signed for billing only, say).
- Undo decision clears the decision. Parent access that was paused stays paused.
Set your age rules
Click Age rules on the Coming of Age page.
- Age of adulthood: when a client usually takes over their own care at your practice. 18 by default, 14 to 25.
- States with another age: used for clients whose address is in that state. Add a state, or Add common US exceptions (Alabama 19, Nebraska 19, Mississippi 21).
- Age a minor may consent to their own care: optional, 10 to 18. It is shown to staff in the dialog ("Under your settings, a client may consent to their own care from 14") and changes nothing on its own.
These ages differ by state and country, so confirm them with your counsel or licensing board. Anyone can open Age rules; only an owner or admin can save them.
Which age applies to a client: one set in their dialog first, then their state's rule, then your practice's age.
On the chart and in Tasks
- Chart banner. On the client's Overview tab, a green banner reads, for example, "Turns 18 on Nov 2, 2026 (in 9 days) · Coming up", with Decide (or Open once a release was sent).
- Tasks card. Each client waiting on a decision is a Coming of age card in Tasks (under All), with Decide, or Finish for a signed release. It opens the dialog. A release still waiting on the client is not a task. The count behind the Tasks badge is worked out overnight and again whenever someone makes a decision.
Who can do this
Anyone on your team who can open the location's clients can decide, send a release, finish it or undo it. Saving the age rules is for owners and admins.