1. Specific Exclusions: Used when certain medical information should be explicitly excluded from the discussion permission

2. Emergency Contact: Include when designating someone who can receive information in emergency situations

3. Language Preference: Used when discussions need to occur in a specific language or through an interpreter

4. Digital Communications Consent: Include when discussions may occur via email, telemedicine, or other digital platforms

5. Third-Party Payment Information: Used when permission includes discussion of payment or insurance matters

1. Schedule A - Detailed Medical Information List: Itemized list of specific medical conditions, treatments, or records that can be discussed

2. Schedule B - Authorized Personnel List: Detailed list of specific staff members or roles authorized to participate in discussions

3. Appendix 1 - Identification Documents: Copies of identity documents for the patient and authorized recipients

4. Appendix 2 - Special Instructions: Any specific protocols or requirements for discussing the medical information