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Doctor Authorization Letter
1. Date and Location: Current date and place of execution of the authorization letter
2. Patient Information: Full legal name, CPR number (Danish personal ID), address, and contact details of the patient granting authorization
3. Authorized Doctor Information: Full name, medical license number, clinic/hospital affiliation, and contact information of the authorized healthcare provider
4. Scope of Authorization: Clear specification of what medical decisions and actions the doctor is authorized to make or take
5. Duration of Authorization: Specific timeframe for which the authorization is valid
6. Patient Declaration: Statement confirming the patient is of sound mind and is voluntarily giving authorization
7. Signatures: Space for patient signature, authorized doctor's acceptance, and witness signatures if required
1. Specific Medical Conditions: Detailed information about particular medical conditions relevant to the authorization, used when authorization is condition-specific
2. Emergency Contact Information: Additional contact persons in case of emergencies, included when patient wants to specify alternate contacts
3. Limitations and Restrictions: Any specific limitations on the doctor's authority, included when authorization is not comprehensive
4. Language Declaration: Statement confirming the patient understands the content if the patient's primary language is not Danish
5. Digital Consent Declaration: Additional section for cases where the authorization will be used in digital health systems
1. Copy of Patient ID: Attached copy of patient's valid identification document
2. Medical History Summary: Relevant medical history documentation when authorization is for specific medical conditions
3. Doctor's License Verification: Copy of the authorized doctor's medical license or authorization
4. Interpreter Certificate: If applicable, certification of translation or interpretation services used
5. Previous Authorizations: Copies of any previous or related medical authorizations that may be relevant
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