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Medical Authorization Letter Template
What Is a Medical Authorization Letter?
A Medical Authorization Letter is a written statement prepared with the intention to permit another individual to be responsible for the medical decisions and treatment of the person named in the letter. Often used to help children and senior citizens when their primary caregivers are absent, this document is crucial in the case of an emergency.
Alternate Names:
- Medical Permission Letter;
- Permission Letter for Medical Treatment.
A printable Medical Authorization Letter template can be downloaded through the link below.
Whether the patient cannot make decisions on their behalf because of their age or mental state, the parent or guardian of a child cannot be reached out to, or you simply want to provide somebody with an authorization to make medical decisions for you when you are incapacitated, this permission will be required by the medical provider before the medical treatment.
How to Write a Permission Letter for Medical Treatment?
Here is how you should compose a Medical Authorization Letter:
- Identify yourself and add your contact details if the medical provider needs to verify certain information.
- Indicate whether you are giving permission to act on your behalf or on behalf of your child or dependent senior citizen in the case of a medical emergency.
- Name the person you authorize to make medical decisions. Usually, it is a family member, close friend, caregiver, or an individual with credible medical experience as a long-time nurse or doctor you trust.
- Specify the duration of the authorization - if you are leaving your children with your relatives, you are giving them permission to handle minor and major medical issues for two weeks of your vacation.
- List the duties the person you trust is allowed to perform. While they may decide whether they consent to surgery or obtain access to your medical records, they may be prohibited from agreeing to certain procedures if you are not comfortable with them for any reason.
- State the insurance details to let the medical provider know whether your insurance company covers medical expenses on short notice.
- Add information for the physician to know - indicate the allergies and drug intolerance you or your child have so that the doctor may act accordingly.
- Confirm your intention to authorize the other individual to have liability for your or your dependents' health by signing the Medical Authorization Letter. You may obtain notarization to make this document even more official; however, it is not legally required.
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