A medical authorization letter is a legal document granting permission to someone other than the parent or legal guardian to authorize treatment for a child, senior citizen, or any other person mentioned in the letter. The letter is usually written if the primary caregiver is either out of town or not available to authorize treatment.
An authorization letter is, in most cases, given to a nanny, babysitter, or other regular caregivers. This is to ensure that should there be any health-related issues, the person under care shall not have to wait for medical treatment. If the temporary caregiver doesn’t have an authorization letter, then the child may have to wait until the legal guardian returns to get proper treatment. In cases where the person under care may require urgent treatment, not having an authorization letter could endanger the persons’ life.
Medical issues are of grave importance and should be treated with the utmost care. For that reason, the permission should only be granted to someone whom the legal guardian trusts. A medical authorization letter can only be issued by the lawful guardian of the person.
To Whom Should You Address the Letter?
A medical authorization letter should be addressed to a specific doctor or hospital in which the treatment shall be sought. If you don’t know this information, then you can simply direct the letter “To Whom It May Concern.”
An authorization letter may also be required if a child is going on a school trip or is traveling with friends, and the legal guardian is not present. The letter will grant permission to the teacher, family member, or other chaperones legal authority to make medical decisions on your behalf.
Authorization Letter Writing Tips
The legal guardian should check with the child’s school or their family doctor before writing an authorization letter, to find out if they are supposed to fill or sign any forms.
The legal guardian should also check the laws to fulfill any requirements made available in their state for the authorization letter to be effective.
The primary objective of this letter is to show that you are aware and you acknowledge by authorization and giving consent to the temporary caregiver to make any medical decisions on your behalf.
The letter should contain:
- The name of the legal guardian, address
- The name and address of the person being authorized
- The name and age of the concerned person
- The reason for writing the letter and medical treatment authorization
- Any special health issues
- The legal guardian may also provide a list of things not allowed during treatment, i.e., the child’s relevant medical history, including any health conditions, vaccines, allergies medications, and any other relevant information.
- Type of medical care you are authorizing
- Parent/legal guardian’s contact information
- The medical insurance information
Types of Medical Treatment Which can be Specified in the Letter
Some of the decisions commonly authorized to be made by temporary caregivers include:
- Medical administration
- Emergency medical transportation
- Routine examination and check-ups
- Anesthesia and any surgical procedures
Medical Authorization Letter Template
Medical Authorization letter
I, _______________, [name] being the _ [state your relationship with the child] of____________ [name of the child] authorize [name of authorized person] to pursue, attain, and accord to routine medical care and treatment, dental medical care and treatment, emergency medical care and treatment, for _______________ [name] as considered obligatory by the healthcare specialist. This letter is effective for the period when my child is under the care of _______________ [name of the care provider] and is valid until revoked by me.
Child’s Information
Full Name: _______________
Address: _______________
Date of Birth: _______________
Authorizing Party
Name: _______________
Address: _______________
Phone Number: _______________
Emergency Contact Person’s
Full Name: _______________
Address: _______________
Phone No.: _______________
Email: _______________
Child’s Health Information
Health Conditions
Allergies
Prescription Medications:
Dosage: _______________ Time: _______________
Dosage: _______________ Time: _______________
Child’s Medical Care and Insurance Information
Dentist: _______________ Phone Number: _______________
Doctor: _______________ Phone Number: _______________
Insurance Firm: _______________
Policy Number: _______________
Policy Holder’s name: _______________
Signature
Authorizing Party’s Signature
Date: _______________
Print Name: _______________
- MS Word
Frequently Asked Questions
A medical authorization letter explicitly identifies the temporary caregivers authorized to make any medical decisions for a child in their care or any member of your family (senior citizen) in your absence, in addition to indicating which types of medical decisions the temporary caregivers are authorized to make.
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