Authorization Letters

Medical Authorization Letter


Remy Honda

Surgery Department Head

Medico Group of Hospitals

67 Yester Moore Avenue

New York, New Jersey 5690

Dated: 12th of May 2012

Subject: Letter for medical authorization

Respected Mr. Honda,

This letter is in regards to my son Bryan Adams who is admitted in your hospital and has to undergo an appendix surgery. I, Patch Adams his father would like to bring to your notice that I authorize your hospital to conduct medical treatment on my son as he is a minor.

My son was admitted in your hospital on 10th of May 2012 as he was having a terrible stomach ache. After the doctor diagnosed him he concluded that my son has an appendix which has to be operated and removed. I was asked to provide a medical authorization letter by the hospital authorities so that your surgeon can go ahead with the operation. As my son is a minor, I am providing the medical authorization letter. I grant the permission to the hospital to perform appendix operation on my son and take the responsibility of all his medical treatment till he recovers completely.

I request you to consider this as a medical authorization letter.

Yours sincerely,

Patch Adams

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