Sample authorization letter to authorize medical treatment

Sample authorization letter to authorize medical treatment


I request you to authorise the grandparents of my daughter Mr. Arvind and Mrs. Chitra Shah to take the decisions regarding my daughter’s treatment in my absence.

We being the parents of my daughter grant permission to Mr. Arvind and Mrs. Chitra Shah to travel along with my daughter for any medical purposes as required. They can sign any documents or take any decisions as required for the treatment in our absence or if by any chance we are not reachable.

In case of any medical urgency, you could contact the below mentioned individuals for any assistance if the bearer is not available for comment. The contact details of the bearer are also mentioned below in this mail.

Mr. Anil Rathore – 981*******
Mrs. Neelima Rathore – 992*******
Mr. Arvind Shah – 011 – 234****
Mrs. Chitra Shah – 987*********

In case of any other queries please feel free to contact any of us.
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  • Sample authorization letter to authorize medical treatment -Hemant Sharma (03/25/14)
  • Sample authorization letter to authorize medical treatment


    I am writing this letter to verify that Mr. Ratanbir Singh Sethi is an occuopant of residential property at House No 1, Gali no 1, Greater Kailash, New Delhi, 110048.

    The above mentioned tenant is residing there for the past 2 years starting from January 2012. This text also verifies that they have this space at the monetary rate of Rs. 25,000/per month.
    The current lease in the name of Mr. Ratanbir Singh Sethi will expire on March 2016.

    If there are any further questions or any other relevant concerns please contact Mr. Hemant Sharma, the respective owner by phone or email at a time that is convenient to you.

    Sample authorization letter to authorize medical treatment


    I, Hemant Sharma grant required permission to ABC Nursing home to act on our behalf and administer any kind of emergency medical care for my parents, which would include my mother and father, in the event that I cannot be reached or while I am travelling.

    This is an authorisation for circumstances in which wither of my parent is in the medical care of the ABC Nursing Home, in accordance with the terms of the care contract.
    It would be effective until December 2015.

    Please find attached a signed medical treatment authorisation form which would be sufficient to act as a proof. I should be the point of contact in case of any non-emergency care. Without my authorisation please do not proceed with any non-emergency care.

    You can reach my by phone at 9990881071, if necessary. I really appreciate your acceptance of this responsibility.

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