Quick question for American Law/Medical professionals

Post » Thu May 19, 2011 12:45 am

My 15 year old daughter is going to Arizona to stay with a friend of hers for a month this summer. I want to write up a letter that acts as a permission slip/waiver to allow her friend's mom and older sister to authorize medical care/treatment in case anything happens while she is down there. Obviously if anything major happened and my daughter needed major medical attention I would be in Arizona ASAP to deal with it, but I would like them to be able to deal with anything minor that might come up.

I ripped this part from a school field trip form:

I, the parent/guardian of the above named minor, grant permission to ____(mom/sister's name)______ to authorize necessary medical services in an emergeny, including injections, anesthesia, surgery and medication, if I cannot be contacted at the telephone numbers shown below; and I agree to be responsible for any expenses not covered by personal insurance that may be incurred as a result of an accident or medical emergency involved the above named minor.


Does that seem appropriate for what I am looking for?

One thing this doesn't cover the medical privacy (HIPAA) part. I will want to allow mom/sister access to my daughter's medical conditions while in their care so I will need something to address that. Anyone have any advice or guidance in writing up a waiver for that purpose?

Should I make a separate letter for the mom and sister or would one with both names work?

Should I worry about specifying dates or make it open-ended?

Thanks in advance for any helpful answers.
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Liv Brown
 
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