The Authorization Letter for Medical Records template is available here for all our guests and readers who want to authorize the other person for the medical treatment of themselves or the minor child etc. Our template is very useful in preparing the legal medical authorization letter to be used across any medical event.

We all go through medical emergencies and this is the time when we need someone who can take the charge of the medical treatment and making relevant decisions. With the medical authorization letter, we can give this charge to any individual who will be authorized to take all the decisions concerning the medical treatment in our absence.

How to Write Authorization Letter for Medical Records

A medical authorization letter is a legal context letter therefore it’s important to draft it in a suitable format. We are here providing some ideas for the format of this median authorization letter below.

  • Write the title of this authorization letter in the top center of the letter.
  • Next, write the name of the person by whom this medical authorization is being made in the “From” section.
  • You further need to write the name of the medical authorities to whom the authorization letter is being addressed in the “To section”
  • Write the subject matter of the letter and also put the salutation for the reader.
    You can now start writing the main body of the letter.
  • Start the main body of the letter with the purpose of this letter.
  • Also, introduce the person whom you want to authorize for the medical authorities in the letter.
  • You also need to mention the rights that the other authorized person can access in medical emergencies.
  • At last end the letter with the gratitude note.

Sample Authorization Letter for Medical Records

Are you feeling confused about drafting the medical authorization letter? If yes then we here have the sample of this authorization letter for you. The sample would work as the reference so that you can accordingly draft the medical authorization letter.

Bhupendra Sharma
New Arena, PO 876529
New Delhi, India

Subject- Medical Authorization Letter


Sarvesh Dhiman
Head of AIIMS Chairman
South Block, 877659
New Delhi, India

Dear Sir

I’m addressing this medical authority letter to appoint Mr. Sonu Kumar as my caretaker for my medical emergency at AIIMS hospital. I’m currently going through cancer treatment at the hospital and I have no relative who can take care of me during this medical emergency.

I hereby announce that Mr. Sonu Kumar would be my legal medical heir to take all the decisions regarding my medical emergency and Medical Records. He is a neighbor of mine and I have utmost faith in him to grant him such a big authority of the medical emergency for records.

I request you to authorize him as my legal caretaker through this medical authorization letter. Feel free to connect with me if you need further clarity on this authorization letter.

Bhupendra Sharma

Authorization Letter  for Medical Records in PDF & Word

You can here check out the interactive template of the medical authorization letter in several formats. We have these templates both in physical and digital formats such as PDF, Word, etc. You can therefore access the medical authorization letter in the electronic format as well with our template. Furthermore, our templates meet all the legal eligibility criteria of the medical authorization letter. You can therefore use it freely for the purpose of drafting your own medical authorization letter.

Authorization Letter for Medical Records Template

PDF | Word

Authorization Letter for Medical Records

PDF | Word

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