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1. Specific Treatment Restrictions: Any specific procedures or treatments that are explicitly NOT authorized

2. Religious or Cultural Considerations: Any specific religious or cultural preferences that should be considered during treatment

3. Insurance Information: Details of medical insurance coverage and billing instructions

4. Medical History Reference: Reference to relevant medical history or conditions that healthcare providers should be aware of

5. Language Preference: Preferred language for communication if in a multilingual context

6. Alternate Decision Maker: Secondary authorized person who can make decisions if the primary representative is unavailable

1. Medical History Summary: Brief summary of relevant medical history, allergies, and current medications

2. Copy of Identity Documents: Copies of identification documents of both patient and authorized representative

3. Proof of Relationship: Documents proving the relationship between patient and authorized representative (e.g., birth certificate for parent-child)

4. Specific Treatment Details: Detailed description of authorized treatments or procedures if applicable