An Authorization Letter For Medical Assistance is essential in situations where an individual needs to delegate medical decision-making authority or grant access to their medical information. Under English and Welsh law, this document provides a clear framework for healthcare providers and authorized representatives to act within specified parameters. It's particularly important for temporary arrangements, foreign travel, or when someone may be unable to make immediate medical decisions. The document must comply with the Mental Capacity Act 2005, Data Protection Act 2018, and relevant healthcare regulations, while clearly outlining the scope and limitations of the authorization granted.
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1. Patient Information: Full name, date of birth, NHS number, address and contact details of the patient
2. Authorised Person/Entity: Details of the person or organization being authorized to assist or access medical information
3. Scope of Authorization: Specific medical treatments, procedures, or information access being authorized, including any limitations
4. Duration of Authority: Time period for which the authorization remains valid, including start and end dates if applicable
5. Declaration and Consent: Formal statement of consent, understanding of rights, and confirmation of voluntary authorization
1. Emergency Contact Information: Secondary contact details for cases when immediate family or primary contacts are unavailable
2. Specific Exclusions: List of treatments, procedures, or information explicitly excluded from the authorization
3. Medical History Summary: Brief relevant medical history section, typically included for complex cases or specific conditions
4. Revocation Clause: Details on how the authorization can be revoked and under what circumstances
1. Schedule 1 - Identity Documentation: Copies of identification documents for both patient and authorized person
2. Schedule 2 - Medical Records: Relevant previous medical records or documentation if applicable to the authorization
3. Schedule 3 - Capacity Assessment: Documentation of capacity assessment if authorization is given by someone other than the patient
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