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1. Emergency Contact Authorization: Additional section for designating emergency contacts and their access rights

2. Specific Treatment Exclusions: Section listing any specific treatments or procedures explicitly not authorized

3. Cross-border Healthcare Provisions: Required when the patient may seek treatment in other EU countries

4. Language Preference: Important in Belgium due to multiple official languages, specifying preferred language for communication

5. Mental Capacity Provisions: Additional provisions for cases where future mental capacity might be questioned

6. Religious or Cultural Preferences: Section detailing any religious or cultural considerations that should be respected in medical treatment

1. Schedule A - Authorized Medical Procedures: Detailed list of specific medical procedures being authorized

2. Schedule B - Authorized Representatives: List of additional persons authorized to receive medical information or make decisions

3. Schedule C - Healthcare Institutions: List of specific healthcare institutions covered by the authority

4. Appendix 1 - Identification Documents: Copies of identification documents for all parties

5. Appendix 2 - Medical History Summary: Optional summary of relevant medical history affecting the authority

6. Appendix 3 - Advance Directives: Any existing advance directives or living will documents to be considered alongside this authority