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1. Special Medical Conditions: Section for listing any existing medical conditions, allergies, or specific health concerns that may affect treatment decisions

2. Financial Authorization: Optional section for authorizing payment arrangements or insurance claims

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

4. Organ Donation Preferences: Section for indicating organ donation wishes in case of terminal situations

5. Language Preference: Section indicating preferred language for communication and need for interpreters

6. Digital Communication Consent: Optional authorization for receiving medical information through digital means

7. Research Participation: Optional consent for participation in medical research or clinical trials

1. Schedule A - Specific Procedures: Detailed list of specific medical procedures or treatments being authorized

2. Schedule B - Prohibited Procedures: List of procedures or treatments specifically not authorized

3. Schedule C - Medical History: Detailed medical history of the patient including past procedures and current medications

4. Appendix 1 - Identification Documents: Copies of required identification documents of patient and authorized representatives

5. Appendix 2 - Previous Medical Records: Relevant previous medical records or test results

6. Appendix 3 - Insurance Information: Details of medical insurance coverage and policy information