1. Emergency Contacts: Additional contacts to be notified in case of emergency, used when the authorized representative cannot be reached

2. Specific Medical Conditions: Detailed information about existing medical conditions requiring special attention, included when relevant to the authorization

3. Treatment Restrictions: Specific treatments or procedures that are explicitly excluded from the authorization scope

4. Religious or Cultural Preferences: Specific religious or cultural considerations that should be taken into account in medical decision-making

5. Language Assistance: Requirements for translation or interpretation services, included when the patient or representative has limited Dutch language proficiency

1. List of Authorized Healthcare Providers: Detailed list of specific healthcare providers or institutions where this authorization is to be used

2. Privacy Policy: Detailed information about how personal medical information will be handled and protected

3. Specific Medical Procedures Authorization: Detailed list of specific medical procedures or treatments that are explicitly authorized or restricted

4. Instructions for Healthcare Providers: Specific guidelines for healthcare providers on how to verify and act upon this authorization