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1. Date and Location: Current date and place of execution of the authorization letter
2. Authorizing Party Details: Full legal name, CNIC number, address, and contact information of the person granting authorization
3. Authorized Party Details: Full legal name, CNIC number, address, and contact information of the person being authorized to make medical decisions
4. Patient Information: Full details of the patient if different from the authorizing party, including name, age, CNIC number, and relevant medical identification numbers
5. Scope of Authorization: Specific medical decisions and treatments the authorized party can approve or decline
6. Duration of Authorization: Time period for which the authorization remains valid
7. Declaration of Sound Mind: Statement confirming the authorizing party is of sound mind and making the decision voluntarily
8. Witnesses and Attestation: Space for witnesses to sign and attest to the document's execution
9. Signatures: Formal signature block for all required parties
1. Emergency Contact Information: Additional contacts to be notified in case of emergency - recommended when the authorized party cannot be reached
2. Specific Treatment Restrictions: Any specific treatments or procedures that are explicitly excluded from the authorization
3. Religious or Cultural Preferences: Specific religious or cultural considerations that should be taken into account during treatment
4. Alternate Authorized Party: Secondary person authorized to make decisions if the primary authorized party is unavailable
5. Digital Communication Consent: Authorization for receiving medical information through digital means - relevant for telemedicine or electronic communications
6. Language Preference: Preferred language for medical communication - important in multilingual contexts
1. Medical History Summary: Brief overview of relevant medical history, ongoing conditions, and current medications
2. Copy of CNIC Documents: Attached copies of CNIC cards of all parties involved
3. Previous Medical Records: Relevant previous medical records or treatment history that may impact future medical decisions
4. Insurance Information: Details of medical insurance coverage and policy numbers
5. Witness Identification: Copies of identification documents of witnesses
Healthcare
Medical Services
Hospital Administration
Legal Services
Insurance
Pharmaceutical
Elder Care
Mental Healthcare
Emergency Services
Public Health
Legal
Medical Administration
Patient Services
Risk Management
Compliance
Medical Records
Emergency Services
Social Services
Patient Registration
Quality Assurance
Medical Director
Hospital Administrator
Legal Counsel
Healthcare Compliance Officer
Patient Relations Manager
Medical Records Officer
Risk Management Officer
Insurance Coordinator
Clinical Department Head
Admissions Officer
Emergency Department Coordinator
Social Services Coordinator
Medical Secretary
Healthcare Facility Manager
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