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1. Specific Health Conditions: Details of any existing medical conditions, allergies, or specific health needs - include if the child has known medical issues

2. Prohibited Treatments: List of medical treatments or procedures that are specifically excluded from the authorization - include if parents want to restrict certain medical decisions

3. Religious or Cultural Considerations: Specific religious or cultural requirements affecting medical treatment - include if relevant to the family

4. Insurance Information: Details of medical insurance coverage and billing procedures - include if insurance coordination is needed

5. Alternative Contact Persons: Additional emergency contacts if grandparents cannot be reached - include for added safety

6. Liability and Indemnification: Provisions protecting grandparents from liability for good-faith medical decisions - include if requested by grandparents

1. Schedule A - Medical History: Detailed medical history of the child including vaccinations, previous conditions, and ongoing treatments

2. Schedule B - Emergency Contacts: Comprehensive list of emergency contact numbers including family members, doctors, and relevant medical facilities

3. Schedule C - Medication Schedule: Current medications, dosages, and administration schedules if applicable

4. Schedule D - Healthcare Providers: List of child's current healthcare providers including primary physician, specialists, and preferred hospital

5. Appendix 1 - Consent to Release Medical Information: Standard form for healthcare providers regarding authorization to release information to grandparents

6. Appendix 2 - Medical Insurance Cards: Copies of relevant medical insurance cards and coverage information