tiktok���˰�

1. Special Medical Conditions: Details of any existing medical conditions, allergies, or special medical needs that are relevant to treatment

2. Medical History Reference: Reference to attached medical history documents when comprehensive medical background is relevant

3. Religious or Cultural Preferences: Any specific religious or cultural considerations that may affect treatment decisions

4. Insurance Information: Details of medical insurance coverage and policy information when applicable

5. Prohibited Treatments: Specific treatments or procedures that are expressly not authorized

6. Alternate Decision Maker: Designation of an alternate person authorized to make decisions if primary grantor is unavailable

7. Translation Certificate: Required when the letter is prepared in multiple languages or for non-English speaking parties

1. Medical History Form: Detailed medical history including past surgeries, medications, and allergies

2. Identification Documents: Copies of relevant ID documents of patient and grantor

3. Proof of Relationship: Documents proving relationship between grantor and patient (e.g., birth certificate for minor child)

4. Insurance Cards: Copies of relevant insurance cards and coverage information

5. Existing Medical Reports: Any relevant current medical reports or test results

6. Power of Attorney: If applicable, legal documentation showing authority to make medical decisions