Authorization Letter

Medical Authorization Letter

Medical Authorization Letter-Is your child sick, or you grandmother bedridden and she is on medication and you are required else here urgently

Is your child sick, or you grandmother bedridden and she is on medication and you are required else here urgently and you will be not able to continue providing your loved one with medication.

Don’t worry you could easily ask your friend, sister or someone close to you to continue with the medical treatment. But to make it official it would be better if you write down, so this is what we would call a medical authorization letter.

This letter is useful in a scenario where by as an adult you can’t continue providing that medical treatment to your child or your ailing mother, so you would need to delegate the responsibility of medical care to the sick person, this is important so as to ensure that they continue receiving the needed medical care when you are away.

Medical Authorization Letter Writing Tips:

After you have the right person in mind to take care of your medical responsibilities while you are away you are ready to write that letter, using the following tips

Simple and keep it short

The letter should not be long, with a lot of unnecessary information so make it short and simple straight to the delegated responsibility being given to them.


Make sure to include the necessary identification of all the people involved and also the person being authorized to take up of your responsibilities while you are away.
Need to write it in a formal and official tone since you are delegating responsibilities. But also need to be a friendly tone, since you are writing to someone to take care of your loved one.
Necessary information

If necessary you may include information such as insurance information and also the doctors’ contact information. Also should have an emergency contact in case something happens. If there is any medicine to be taken, ensure to state it and also give the dosage of the medicine.

With all this in mind, it makes it easier for you to write this letter when you are authorizing that person to take up your duties.

Medical Authorization Letter Template

Use our free Medical Authorization Letter to help you get started. Simply download the .doc or pdf file and customize it. If you need additional help or more examples check out some of the sample letters below.

We/I, _________ (name of parent(s)), of _______ (name of individual requiring medical attention), give full authority to have medical responsibility to _____________ while am away on my trip from ________ (date leaving) to _______ (date coming back). During my trip away you will be expected to give ______ the stated detailed prescription below.

Insurance Company __________ (details of company and also contact information)
Prescription ____ (details on prescription and how they are to be taken)


_______ (name of sender)

Medical Authorization Letter Sample, Email and Example/Format


10th March 2013

I, Anthony Mumo, the parents of Winy Angaya am giving full medical authority concerning the health state concerning my daughter. She currently has asthma and pneumonia.

She needs to be monitored on a daily basis. I give medical authority to Brenda Angaya in my absence while am abroad from 15th to 25th of October. You will be required to give her the following medicines when needed or as prescribed on the medicine.

I prefer in case of an emergency, if needed to be taken to Matter Hospital. And in the case if this emergency please contact me on this number 0713071251. Thank in advance for accepting the responsibilities being given to you.


Anthony Mumo

Email Format

This type of authorization letter would be addressed to the concerned medical authorities in relation to disclosure of any medical information. This would signify the detailed disclosure, consent on terms & conditions & related factors briefed up.

Dear Mr. Sahil;

With reference to the disclosure notifications on medical terms dated 25th Aug’ 2010. by the intensive unit; I the undersigned employee from general ward section of your esteemed intensive unit would like to hereby consent & authorize to make use of & disclose the personal medical information as may be required as per the notifications announced.

Further I am also ready to do the needful to update the medical information & also take necessary efforts to contribute in the task to make it possible in a convenient way.

Further having taken advantage of the medical campaign organized a week before; thereby enclosing the medical report recently diagnosed by the doctor prescribed by the intensive unit.

Kindly acquaint us the course of action to complete the authorization formality and if any other documents also need to be submitted.

Yours Sincerely,

Mr. Akshay Purohit.


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