In severe medical cases, surgeries and other operations need to be performed. However, to be able to do this, the guardians of a patient are asked for permission to perform the said surgery, operation, or any part of a medical treatment.

Authorization letters are often used for business purposes. You can also use authorization letters to allow someone to act your behalf, to grant a request, or to delegate specific responsibilities. But it can also be used to authorize medical treatment. Patients that need to undergo a sensitive medical treatment, need to give an authorization to their legal guardians. It is not just for legal purposes, but it is also for the benefit of the physician assigned to the patient. It can also be used to release the results of medical treatment or to finalize all transactions.

The authorization letter should contain all the important details of both the legal guardian and the patient. In some cases, signatures are not enough. Sometimes, notarization is required to process the authorization letter. Contact information of the legal guardians should be stated. But most importantly, it includes personal information and medical background of the patient. In most cases, consulting a legal professional is needed. Below is an example letter to authorize medical treatment.

SAMPLE AUTHORIZATION LETTER

Medical Treatment Authorization Letter

TO WHOM IT MAY CONCERN:

As the guardians of Mr. John Smith, we authorize the bearer of this letter to approve medical treatment for our father. We entrust our father’s condition to the physician assigned to our father’s medical treatment.

Guardian 1
Jenny Smith
Work Phone: 592-0323
Mobile Phone: 0903420-4234

Guardian 2
Bryan Smith
Work Phone: 893-9323
Mobile Phone: 0903-410-4234

Insurance Carrier
& Policy Number Fortune Teller Insurance Company
84901-39842-9424

PATIENT’S PERSONAL INFORMATION
Date of Birth: October 16, 1943
Blood Type: Type AB
Known Allergies: Oily and fatty foods
Being Treated For
These Chronic Conditions: High blood pressure, consecutive heart attack events, other complications such as inflammation in the eyes.

Doctor: Dr. Jenna Smith
Doctor’s Contact number: 542-3242

Thank you,
_________________________________________
Guardian 1’s signature
Guardian 1’s Full Name
_________________________________________
Guardian 2’s signature
Guardian 2’s Full Name

Subscribed and sworn to before me this 29th Day of May 2010.

_______________________________________________ Notary Public
__________________________________________ County, New York

Doctor’s Hospital Incorporation
2482-942-424