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Medical Authorization Form

A medical authorization form is produced when the parent or the guardian want to confer the authority to the medical practitioners or the health care providers to conduct their medical process on the concerned person in case of an emergency. It is not always possible to stay with the child so that this medical authorization form is the way to transfer the authority of the child on whom you have trust. The format of this form contains information regarding the concerned person’s medical condition.

The template of this form carries information about the child and his/her personal detail, including the date of birth. Generally, the authorization is given to the grandparents or the babysitter who looks after the child in the absence of his/her parents. The form should be signed by the parents as to give the responsibility of the children. The form also contains information about any kind of medical insurance of the child. Below an example of this form is provided.

You can download the sample of this form in both PDF and word file. Modification of the format is up to you.

Medical Authorization Form

Medical Authorization Form sampleDownload Easy to Edit Medical Authorization Form at only $3.00

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