Letter of Authorization for Medical Treatment

There are times when people need to undergo a life changing medical procedure, especially if they had a serious accident or disease. Doctors need the approval of the guardians in order to continue the operation, which is why letters to authorize medical treatment is necessary.

Under legal terms, doctors and nurses cannot operate the patient without the consent of the family. The family can file law suits against the hospital if ever the patient dies or have more serious complications after the unauthorized operation.

An authorization letter is their legal protection to ensure that the hospital don’t have any liabilities to the patient’s family after the said operation. It is also a way to put the consent of the family in writing.

The letter must be brief, information-centered and has to be edited in a word application and printed on a piece of paper to make it look formal. Personal information and contact numbers of the guardians, the patient, and the health insurance company, the doctor or surgeon, and the hospital has to be seen on the letter.

The guardians must sign the letter and sent to the notary public for authentication. When all is done, the surgeon can now operate on the patient.

Here is an example of a letter to authorize medical treatment:



To Whom It May Concern:

As the parents of Joan Williams, we allow the bearer of this letter to approve medical treatment to our daughter. We put our daughter’s life in the hands of her surgeon.

Guardian 1:
Janet Williams
Work Phone: 791-3254
Mobile Phone: 0916-571-8442

Guardian 2:
Andre Williams
Work Phone: 272-3565
Mobile Phone: 0939-049-9277

Insurance Carrier: Jigka Life Insurance Company
Policy Number: 45390-49927-4297

Child’s Personal Information:
Date of Birth: December 3, 1994
Blood Type: O
Known Allergies: Shrimp, Peanuts
Being Treated for these Chronic Conditions: Chronic obstructive pulmonary disorder, Bronchiectasis, other events of difficulty breathing

Physician: Dra. Barbara Barbosa
Phone Number: 776-5693

Thank you,
Janet Williams
Mother’s Signature

Andre Williams
Father’s Signature

Subscribed and sworn to before me on this 28th of September 2010

____________________________________ Notary Public
__________________________________ County, Arizona

Pejoo Health Care Incorporation

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