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1. Specific Treatment Exclusions: List of treatments or procedures specifically not authorized, used when patient wants to exclude certain medical interventions

2. Insurance Information: Details of health insurance coverage and billing authorization, included when insurance coverage is relevant

3. Language Assistance: Acknowledgment of translation services if the patient's primary language is not Arabic or English

4. Organ Donation Authorization: Specific consent for organ donation, included when patient wishes to address this aspect

5. Alternative Medicine Preferences: Authorization for traditional or alternative medical treatments, included when relevant to patient's care preferences

1. Schedule A - Authorized Medical Procedures: Detailed list of specific medical procedures and treatments being authorized

2. Schedule B - Authorized Representatives: List of individuals authorized to make medical decisions, including their contact information and relationship to patient

3. Appendix 1 - Patient Rights Summary: Summary of patient rights under Saudi healthcare laws and regulations

4. Appendix 2 - Religious Guidelines: Summary of relevant Islamic medical ethics guidelines and religious considerations