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1. Mental Capacity Declaration: To be included when the patient wants the authorization to become effective only if they are deemed mentally incapacitated

2. Specific Treatment Exclusions: Section listing any specific medical treatments or procedures that are explicitly excluded from the authorization

3. Alternative Representatives: Designation of alternative authorized representatives in case the primary representative is unavailable

4. Religious or Cultural Preferences: Special instructions regarding religious or cultural considerations in medical treatment

5. Organ Donation Instructions: Optional section for organ donation preferences and authorization

1. Schedule 1: Glossary of Medical Terms: Definitions of medical and technical terms used in the authorization form

2. Schedule 2: List of Healthcare Providers: List of specific healthcare providers or facilities where the authorization is to be used

3. Appendix A: Identity Documentation: Copies of HKID/passport of patient and authorized representative

4. Appendix B: Capacity Assessment Form: Optional medical assessment form confirming the patient's mental capacity at the time of signing