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1. Identification of Parties: Details of the grandparents, parents, and child including full legal names, CNIC numbers, addresses, and relationship
2. Purpose and Scope: Clear statement of the purpose of the authorization and its intended scope of medical decision-making authority
3. Grant of Authority: Specific powers being granted to the grandparents regarding medical decisions and treatment consent
4. Duration of Authorization: Specific time period for which the authorization is valid, including start and end dates
5. Emergency Contact Information: Contact details for all relevant parties, including parents, grandparents, and primary healthcare providers
6. Medical Information: Essential medical information about the child including allergies, current medications, and pre-existing conditions
7. Limitations of Authority: Clear statement of any restrictions or limitations on the grandparents' decision-making authority
8. Signatures and Attestation: Formal execution section including signatures of parents, grandparents, and witnesses with dates
1. Religious or Cultural Preferences: Specific instructions regarding religious or cultural considerations in medical treatment
2. International Travel Authorization: Additional authorization for medical treatment during international travel, if applicable
3. Insurance Information: Details of medical insurance coverage and billing instructions
4. Revocation Clause: Specific terms under which the authorization can be revoked before its expiration
5. Alternative Guardian Designation: Designation of alternative authorized persons if grandparents become unavailable
1. Schedule A - Child's Medical History: Detailed medical history including vaccinations, past surgeries, and chronic conditions
2. Schedule B - Approved Medical Facilities: List of pre-approved hospitals, clinics, and healthcare providers
3. Appendix 1 - Identity Documents: Copies of CNIC cards, birth certificates, and other relevant identification documents
4. Appendix 2 - Emergency Protocols: Specific procedures to follow in different types of medical emergencies
Emergency Care
Grandparents
Guardian
Healthcare Provider
Legal Custodian
Medical Care
Medical Decision
Medical Facility
Medical Personnel
Medical Records
Medical Treatment
Minor Child
Non-Emergency Care
Parents
Preventive Care
Primary Care Physician
Routine Care
Serious Medical Treatment
Temporary Medical Guardian
Treatment Authorization
Urgent Care
Valid Period
Witnesses
Scope of Authority
Duration
Medical Consent
Emergency Powers
Liability
Indemnification
Privacy and Confidentiality
Medical Information Release
Insurance and Payment
Revocation Rights
Religious and Cultural Considerations
Travel Authorization
Record Access
Communication Requirements
Witness and Attestation
Governing Law
Dispute Resolution
Severability
Amendment
Termination
Healthcare
Legal Services
Insurance
Education
Child Care
Medical Tourism
Family Services
Emergency Services
Legal Affairs
Medical Administration
Compliance
Risk Management
Patient Services
Emergency Medicine
Pediatrics
Medical Records
Insurance Processing
Clinical Operations
Healthcare Administrator
Medical Director
Family Physician
Emergency Room Doctor
Pediatrician
Legal Counsel
Compliance Officer
Medical Records Manager
Insurance Coordinator
School Nurse
Hospital Administrator
Clinical Director
Patient Services Coordinator
Risk Management Officer
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