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1. Insurance Information: Details of medical insurance coverage and policy numbers, included when treatment requires insurance coverage

2. Medical History Reference: Reference to attached medical history documents, included when relevant to the authorized treatment

3. Specific Restrictions: Any limitations or specific exclusions to the authorization, included when certain procedures are not to be authorized

4. Alternative Decision Maker: Designation of alternative person to make decisions if primary grantor becomes unavailable, included for long-term authorizations

5. Religious or Cultural Preferences: Specific religious or cultural considerations affecting treatment, included when relevant to patient care

6. Organ Donation Authorization: Specific permission for organ donation in critical situations, included when relevant

7. Photography Consent: Permission for medical photography or recording, included when procedures may require documentation

1. Medical History Form: Detailed medical history including allergies, previous conditions, and current medications

2. Identification Documents: Copies of relevant ID documents of patient and person granting authorization

3. Specific Treatment Details: Detailed description of authorized medical procedures or treatment plan

4. Insurance Documentation: Copies of insurance cards and relevant policy information

5. Power of Attorney: If applicable, legal documentation proving authority to grant medical permission