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1. Specific Medical Conditions: Details of any existing medical conditions, allergies, or ongoing treatments that the authorized person should be aware of

2. Religious/Cultural Preferences: Any specific religious or cultural considerations that should be taken into account during medical treatment

3. Insurance Information: Details of medical insurance coverage and policy numbers

4. Restricted Procedures: List of any medical procedures that explicitly require parent/guardian approval and cannot be authorized by the temporary caregiver

5. Witness Section: Space for witness signatures and details, recommended for additional legal security

6. Official Attestation: Section for official attestation by relevant authorities or notary

1. Medical History Form: Detailed medical history of the minor including vaccinations, previous surgeries, and chronic conditions

2. Medication Schedule: List of current medications, dosages, and administration schedules if applicable

3. Healthcare Provider Information: List of child's regular doctors, specialists, and preferred medical facilities

4. Copy of Identity Documents: Copies of relevant identity documents of all parties involved

5. Insurance Card Copies: Copies of medical insurance cards and relevant policy documentation