Medical Authorization Letter For Minor Template for Philippines

1. Parent/Guardian Information: Full legal name, relationship to minor, contact details, and valid government ID information of the authorizing parent(s)/legal guardian(s)

2. Child Information: Full legal name, date of birth, and other identifying information of the minor

3. Authorized Caregiver/Medical Provider: Identity and contact information of the person(s) or medical facility authorized to provide medical care

4. Scope of Authorization: Specific medical treatments, procedures, or decisions that are being authorized

5. Duration of Authorization: Clear statement of the time period for which the authorization is valid

6. Emergency Contact Information: List of emergency contacts in order of priority

7. Declaration and Signature: Formal declaration of authority and authentic signatures of authorizing parties

1. Medical History Form: Detailed medical history of the minor including vaccinations, previous conditions, and treatments

2. Copy of Valid ID: Photocopies of valid government IDs of parent(s)/guardian(s) and birth certificate of minor

3. Insurance Card Copy: Copy of current health insurance card if applicable

4. Emergency Contact List: Detailed list of emergency contacts with complete contact information