Does anyone have an example of a letter to write to grant the power to my Mom, and SIL's who will be watching Faith for 2 weeks while we are away. I want this jsut in case she gets hurt and will need to be seen by the doc.
We, _Sonya F and Michael F______, hereby voluntarily consent to the rendering of such care, including diagnostic procedures, surgical and medical treatment and blood transfusions, by medical doctors, hospitals or their authorized designees, as may in their professional judgement be necessary to provide for the medical, surgical or emergency care of my _________________children_________
(relationship)
_______Charles A and Josephine H___
(hereafter “dependent”) – Full Name
I further give my consent to ____Bernice C, Nancy F, or Krista C______________, (hereafter “caregiver”) – Full Name
who will be caring for my dependent for the period ____Nov 5, 2009____ through ___Nov 9, 2009___, to arrange for routine or emergency medical and/or dental care and treatment necessary to preserve the health of my dependent. In the event that my dependent is injured or ill while under the care of the caregiver, I hereby give permission to the caregiver to provide first aid for said dependent and to take the appropriate measures, including contacting the Emergency Medical Service (EMS) system and arranging for transportation to the nearest emergency medical facility.
In making medical decisions on my behalf for the benefit of my dependent, I direct that the caregiver attempt to contact me. However, if medical care becomes essential, I give permission to the caregiver to make such decisions regarding such treatment as deemed appropriate by the medical doctor, hospital or their authorized designee. In furtherance of any treatment decisions to be made by the caregiver on my behalf for the benefit of my dependent, I authorize the caregiver to request, obtain, review and inspect any and all information bearing upon my dependent’s health and relevant to any such decisions to be made respecting such treatment.
I acknowledge that no guarantees have been made to me as to the effect of such examinations or treatment on the condition of my dependent and that I am responsible for all reasonable charges in connection with the care and treatment rendered to my dependent during this period.
