Medical Authorization Letter



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How to write a Medical Authorization Letter? Do you need a Medical Authorization Letter?
Download this sample of a medical treatment authorization letter for minor template that will perfectly suit your needs.

When you are looking for a Medical Authorization Letter or Medical Power of Attorney (POA), for example to authorize the emergency treatment for someone you love, it's better to start with a professional document template like this one. This will save you time and frustration. Since time and your mood are precious, don't waste it. Our collection of online health and medical templates aims to make life easier for you. Our site is updated every day with the latest professional health and healthcare document templates.

Medical treatment authorization letter for minor template

  • To Whom It May Concern,
  • Dear Mr./Mrs. {{Name}},
  • We/I, {{name of parent{{s}}}}, of {{name of individual requiring medical attention}}, give full authority to have medical responsibility to while am away on my trip from {{date leaving}} to {{date coming back}}. 
  • During my trip away you will be expected to give {{Name medication}} the stated detailed prescription below.
  • Insurance Company {{details of company and also contact information}}.
  • Prescription {{details on prescription and how they are to be taken}}.
  • This acknowledges that we, the undersigned, parent(s) or legal guardian(s) of {{Name of participant}} recognize the potentially hazardous nature of the sport of ULTIMATE that an injury might be sustained. 
  • These injuries include but are not limited to PERMANENT DISABILITY, BLINDNESS, PARALYSIS AND DEATH. 
  • In the event of such an injury to my child and we (I/my spouse/guardian) cannot be contacted, we give permission to qualified and licensed EMTs, physicians, paramedics, certified athletic trainers, and/or other medical or hospital personnel to render such treatment.
  • Child’s Medical Insurance Carrier: 
  • Specific facts concerning child’s medical history including allergies, medications being taken, chronic illness or other conditions which a physician should be alerted to: 
  • Completed forms should be given to the chaperone.
  • If you have any questions, please feel free to contact me directly.
  • Yours sincerely,

By providing you this Authorization letter template, we hope you can save precious time, cost and effort and it will help you to get things done and a better life. This Medical Authorization Letter is intuitive, ready-to-use and structured in a smart way, fully customizable and downloadable using various devices. It’s quick, easy, convenient, and will get you the perfect form. Do not pass on this easy opportunity. Try it now and let this Medical Authorization sample make heavy things a little easier.

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