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Authorization for Medical Treatment Letter

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The Authorization for Medical Treatment Letter is designed to provide an individual with a formal way to authorize medical treatment for their child/dependents in the case of an emergency, accident, injury or any other condition requiring medical treatment. This form also has space for the medical insurance carrier information to better expedite treatment in case of an emergency. This form can be used by parents or other individuals who have children or other dependents and want to authorize medical treatment for those dependents in case of an emergency.

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