1. Interpreter Details: To be included when the patient requires an interpreter or the permission letter needs to be explained in another language

2. Guardian Information: To be included when the patient is a minor or lacks capacity to give consent, including guardian's details and authority

3. Revocation Instructions: Optional section explaining how the patient can revoke this permission if they choose to do so

4. Emergency Contact: Optional section for including emergency contact details who can be consulted about the permission if needed

1. List of Specific Medical Records: Detailed list of specific medical records or information types covered by the permission, if the scope is limited to particular records

2. Privacy Notice: Standard privacy notice explaining how the medical information will be protected and used, in compliance with Hong Kong privacy laws

3. Authorized Healthcare Providers List: If multiple healthcare providers are authorized, a comprehensive list with full contact details and any specific limitations for each