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An Authorization Letter For Medical Result is a crucial document in the Philippine healthcare system, designed to facilitate the secure and legal transfer of medical information to authorized parties. This document becomes necessary when patients need to delegate access to their medical results to family members, legal representatives, or other authorized individuals, such as for employment requirements, insurance claims, or during medical emergencies. The letter must comply with the Data Privacy Act of 2012 and other relevant Philippine healthcare regulations. It typically includes specific details about the medical results being requested, the duration of the authorization, and clear identification of all parties involved. The document serves as a protection mechanism for healthcare providers while ensuring patient privacy rights are maintained in accordance with Philippine law.

1. Date and Place: Current date and location where the letter is being executed

2. Recipient Details: Name and address of the medical facility or healthcare provider holding the medical results

3. Patient Information: Complete legal name, date of birth, and contact information of the patient whose medical results are being authorized for release

4. Authorized Person Details: Complete information of the person being authorized to receive the medical results

5. Purpose Statement: Clear statement of the purpose for which the authorization is being granted

6. Scope of Authorization: Specific medical results or records being authorized for release, including relevant dates

7. Duration of Authorization: Validity period of the authorization

8. Patient's Declaration: Statement confirming the voluntary nature of the authorization and understanding of its implications

9. Signature Block: Space for patient's signature, date of signing, and contact information