The Medical Permission Form For Caregivers is essential in situations where someone other than a parent or legal guardian needs authority to make medical decisions for a care recipient in Nigeria. This document is particularly crucial for professional caregivers, family members providing care, or educational institutions responsible for children during school hours. It complies with Nigerian healthcare regulations, including the National Health Act 2014 and the Child's Rights Act 2003 where applicable. The form includes comprehensive medical information, emergency contacts, specific authorizations for different types of medical care, and clear protocols for various situations. It's designed to protect all parties involved while ensuring prompt medical care can be accessed when needed, with proper documentation and legal backing.
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1. Parties: Identification of the person granting permission (parent/guardian), the caregiver receiving authorization, and the person receiving care
2. Background: Brief context explaining the need for caregiving arrangement and duration
3. Definitions: Clear definitions of key terms used in the document including 'emergency care', 'routine care', 'medical treatment' etc.
4. Medical Information: Essential medical information about the person receiving care, including current conditions, allergies, and medications
5. Scope of Authority: Specific medical decisions and actions the caregiver is authorized to make or take
6. Emergency Protocols: Clear procedures for emergency situations and extent of caregiver's decision-making power
7. Contact Information: List of primary contacts, alternative emergency contacts, and relevant medical providers
8. Duration and Validity: Period for which the permission is valid and circumstances under which it may be terminated
9. Signatures and Witnessing: Formal execution section including signatures of all parties and witnesses as required under Nigerian law
1. International Travel Authorization: Additional permissions for international travel with the person receiving care, required if travel may be necessary
2. Special Procedures Authorization: Specific permissions for any specialized medical procedures that may be anticipated
3. Religious or Cultural Preferences: Specific instructions regarding medical care based on religious or cultural beliefs
4. Insurance Information: Details of medical insurance coverage and billing procedures, if applicable
5. Temporary Transfer of Authority: Provisions for temporarily transferring authority to another caregiver if needed
1. Schedule A - Medical History: Detailed medical history including past surgeries, conditions, and treatments
2. Schedule B - Medication List: Comprehensive list of current medications, dosages, and administration schedules
3. Schedule C - Emergency Contacts: Detailed list of all emergency contacts with multiple contact methods
4. Schedule D - Healthcare Providers: List of current healthcare providers including specialists and their contact information
5. Appendix 1 - Medical Authorization Card: Portable card summarizing key permissions and contact information for caregiver's immediate use
6. Appendix 2 - Emergency Protocol Checklist: Step-by-step checklist for caregivers to follow in various emergency scenarios
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