A medical release letter is a document communicating the requirement of medical attention and authorization regarding medical care to any concerned person, organization, or authority. As it is a legal document, it should be drafted properly. There are certain steps you can follow to ensure that your medical release letter serves its exact purpose.
Medical release letters are important documents that authorize a third party to take judicious steps regarding medical attention and care of a person, as and when required. It is a legal document giving permission to the holder of the document to care for someone in absence of the undersigned. This letter is, at times, misunderstood for a medical information release letter. It is important to understand that while the latter authorizes access to private medical information of a person to a third party, the former simply gives permission to attend to the medical needs by a third party.
As this document is important and has legal implication, utmost care is required while drafting this letter. The information must be precise, without the scope of any ambiguity. Also, the letter must be signed by either of the parents, or guardian, in case of minors. There are certain steps that you can keep in mind while drafting a medical release letter.
- Kids going for camping, or an overseas trip organized by a school or college
- Kids staying with grandparents or babysitter, when parent/s or guardian/s are out of town
- School sports team, which your ward is a member of, visiting another institute for a game
- Kids traveling to another state or country with a person other than parent/s or guardian/s
- Medical Authorization Form
- Medical Permission Letter
- Authorization Letter for Medical Care
- Consent Form for Medical Care
- Medical history
- Any evident family medical history
- Allergies, if any
- Any health disorder
- Ongoing medication or treatment, if any
- Contact information of Family Physician
- Details of Insurance cover
|Name of the Undersigned: Mr. John Smith
Relationship with Minor: Father/Guardian
Address: 312/B, Summer Chateau, Rustic Lane, Tucson AZ 25412, USA
Phone: Home — 555-12333-12333
Phone: Work — 555-12334-12334
Phone: Mobile — 555-12335-12335
Name of the Minor: Ms. Eva Smith
Authorized Person: Mr. Mark Johnson
Family Physician: Dr. Anthony, MD
Dentist’s Name: Dr. Dunlap
|Insurance Company: XYZ Life and Health Insurance
Policy Holder’s Name: Mr. John Smith
Address: 312/B, Summer Chateau, Rustic Lane, Tucson AZ 25412,USA
Relationship with Child: Father/Guardian
Policy Type: Group
Policy Number: #4545
Declaration of Consent: (To be signed in presence of legalized notary public):
As a parent/legal guardian of Ms. Eva Smith, I hereby authorize and grant permission, in case of emergency or non-emergency to Mr. Mark Johnson thereof, to take an appropriate decision regarding medical or dental administration required by my daughter, in case of accidental injury or illness, until such time as I can be contacted. This permission includes, but is not limited to, administering first aid, performing diagnostic procedures, treatment procedure, and using ambulance and/or any recommended surgical procedure by and under qualified and trained professionals. I understand and accept that the success of any treatment administered has not been guaranteed. I authorize the medical facility to dispose any sample, specimen, or tissue taken from the above-named minor.
This document is valid from March 15, 2013 to March 20, 2013.
Date (March 15, 2013)
Name of Notary Official: Mr. Gordon Nash
This above-given letter is a sample indicating that the undersigned has authorized the maternal uncle regarding his daughter’s medical care for a time period of 6 days. In case a medical release letter is being furnished to a boarding school, validity of the document should be one year and renewed for another year, until your child graduates or transfers to another school. For a camping trip, the validity of this document will be from the day of departure for the camp to the day of arrival.
A medical release letter ensures that your child/children get required treatment in your absence. So, be careful with the information that you furnish in this document. In case you are undecided about the matter to be included, use samples available with the hospitals, organizations, and on the web.