1. Mental Capacity Statement: Required when the patient has diminished mental capacity, including medical professional's assessment

2. Emergency Contact Provisions: Additional emergency contacts and their role in decision-making hierarchy

3. Specific Treatment Authorizations: Detailed authorizations for specific medical procedures or treatments

4. Religious or Cultural Preferences: Specific religious or cultural considerations that should influence medical decisions

5. Language Assistance: Required when the patient or representative needs translation services

6. Digital Access Authorization: Specific provisions for accessing digital medical records and online healthcare portals

7. Foreign Travel Provisions: Additional authorizations needed for medical treatment while abroad

1. Identity Verification Documents: Copies of valid ID documents for patient and authorized representative(s)

2. Capacity Assessment: Medical professional's assessment of patient's capacity to make decisions, if relevant

3. Existing Medical Directives: Copies of any existing advance directives or living wills

4. Healthcare Provider List: List of current healthcare providers who need to be informed of the authorization

5. Specific Medical Information: Relevant medical history or conditions that impact the scope of authorization