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1. Specific Restrictions: Any limitations or conditions placed on the authorization - include when there are specific treatments excluded or conditions attached

2. Alternative Treatment Options: List of approved alternative treatments - include when multiple treatment options are being considered

3. Financial Authorization: Permission for billing and insurance matters - include when financial responsibility needs to be addressed

4. Religious or Cultural Considerations: Specific religious or cultural requirements affecting treatment - include when relevant to patient care

5. Interpreter Confirmation: Details of interpreter if used for non-English speaking patients - include when language assistance was required

6. Mental Capacity Statement: Confirmation of mental capacity to make medical decisions - include when there might be questions about decision-making capacity

1. Detailed Medical History: Comprehensive medical history including allergies, current medications, and previous procedures

2. Treatment Plan: Detailed description of the proposed treatment plan, including steps, timeline, and expected outcomes

3. Consent Forms: Specific consent forms required by the healthcare provider or facility

4. Advanced Directive: If applicable, copy of any existing advanced directive or living will

5. Supporting Medical Documentation: Relevant test results, diagnoses, or specialist recommendations