Medical authorization forms are documents which should be signed by a patient or an individual who will be authorizing other parties to either administer emergency care and treatment to him, as well as obtain his confidential medical information. With the form, the patient or individual will be able to specify the limitations that he sets out to be adhered to by the organization that he is authorizing. Furthermore, medical authorization forms protect both the patient and the authorized organization from any issues relating to medical privacy and confidentiality.

Types of Medical Authorization Forms

Emergency Medical Authorization Form – This is the type of medical authorization form that educational institutions use to document their students’ emergency and medical information. In the form, there are four sections which must be completed by the student and his legal guardian or parent. The first section is intended for collecting the student’s basic data such as his name, his address, the phone numbers of his parents, and his grade level along with the name of his teacher. The second section is for documenting the details of the student’s residential parent or guardian who is living with him while the third section identifies the alternate persons to be notified in the event of an emergency. And in the last section, information about the student’s family will be disclosed such as the marital status of the student’s parents, the type of housing that the student’s family is living in, and whether the student is living with his parents or not.

Emergency Medical Authorization Form

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Emergency Medical Care Authorization Form – The purpose of this form is to allow physicians and medical practitioners to provide immediate medical care to a specific individual during emergencies. The form is often a requirement to be filled out by parents of children who are participating in activities and events conducted by organizations. One of the most important pieces of information which should be stated in the form would be the names of the parent’s choice of staff members from a medical institution or clinic whom he authorizes to administer medical procedures to his child or children. In addition, the parent should also disclose the insurance information of his child including the insurance policy name and number.

Emergency Medical Care Authorization Form

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Medical Information Release Authorization Form – If the intent of an individual is to authorize an organization or a party to acquire and use his medical information, then a medical information release authorization form should be used. In this form, the authorizing individual will be able to state the details of the recipient or receiver of the medical records and information along with the purpose of the disclosure, and the descriptions of the information to be disclosed.

Medical Information Release Authorization Form

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Medical Prior Authorization Form – Physicians are the ones who will be filling out this form type. Basically, a medical prior authorization form is a required document to be completed by the physician in order to inform the insurance company of a patient about the needed medications and treatments which may be made cost-efficient with the approval of the insurance company. The form has six sections. The general information of the insurance member or insurance policyholder will be stated in the first section of the form and is followed by the reason for the physician’s referral in the second section. The third section, on the other hand, is for the details of the physician who is the requestor while the fourth section is for the insurance provider’s information, the fifth section for inpatient admission details, and the sixth section is for the additional information to be noted by the insurance company.

Medical Prior Authorization Form

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Minor Medical Authorization Form – This type of form has identical contents to a medical power of attorney form. It contains two parts wherein the first part is comprised of statements indicating the authorization of the minor’s parents, the names of the authorized agents, and the effectivity period of the power. The second part is to be filled out by a notary public who had positively identified the parents of the minor, the minor, and the agents.

Minor Medical Authorization Form

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Reasonable Accommodation Medical Authorization Form – Employees who are disabled, whether physically or mentally, yet are still able to perform at work should use a reasonable accommodation medical authorization form. The purpose of this form is to request for special accommodation from the company to help the employee in effectively performing his daily tasks and responsibilities in the workplace. Two sections comprise this form type and the first section is to be filled out by the employee while the second section must be completed by the employee’s physician or health care provider.

Reasonable Accommodation Medical Authorization Form

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Medical Authorization Form FAQs

Can a doctor immediately access a patient’s medical records without the patient’s signed medical authorization form?

No. The medical records and information of the patient are of the patient himself and could only be accessed with his granted consent and authorization.

Can a court order authorize the release of a patient’s medical information?

Yes. A court order can authorize the authority to acquire the medical records and information of a patient which will then be used as a proof or evidence in a lawsuit or case.

Medical Authorization Form Sample

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Medical License Authorization Form

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Size: 235 KB

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Medical Representative Authorization Form

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Size: 124 KB

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Medical Treatment Authorization Power Form

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Medical Authorization Form Formats

Medical authorization forms can be made with different formats depending on the preferred method of the involved parties as to how the form will be used. For instance, if the involved parties prefer to use the form physically or by having the form printed out, then the format to be used should be in “.DOC” or word document format. This is the basic type of format which is widely used in creating any variety of form.

Pediatric Medical Authorization Form

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Workers’ Compensation Medical Authorization Form

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Size: 23 KB

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Youth Medical Authorization Form

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On the other hand, electronically sending, filling out, and submitting a medical authorization form would require the document-preparer to create the form in “.PDF” or portable document file format. This is a type of format which shows the print version of the form, however, the form can be filled out automatically or electronically by making the form’s entry fields and buttons be clickable with the aid of a “.PDF” converter.

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