Medical Care Authorization Form

ADVERTISEMENT

Medical Care Authorization Form
I ____________________of ____________________ do hereby appoint
_____________________of ____________________to seek and obtain medical
care and treatment for my children, ____________________________________
________________________________________________________________
________________________________________________________________
which he/she believes to be necessary for the health and well being of my said
child/children including any surgery authorized by a licensed physician.
I give and grant unto him/her full power and authority to do and perform all and
every act, deed and matter and things whatsoever to promote the health and
welfare of my said child/children as fully and effectually to all intents and
purposes as I might or could do in my own proper person if personally present. I
hereby declare that any act or thing lawfully done hereunder shall be binding on
me.
Dated this ______day of____________________20______
_______________________________________________
Signature of parent or legal guardian

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go