46 Free Authorization Letter Samples & Templates

You might not need to fill a lot of forms and documents when admitting a new patient but when it’s time to release him after or during the treatment, there are some complicated documents that you need to fill and sign as his doctor or physician. Along with many other forms, there is the Release Authorization Form. This is a legal document that state the consent of the doctor about the release of the patient. If the release is after full recovery, the doctor will just advice and recommend some tips to the patient about how to be careful after full recovery and if the discharge is during treatment or recovery, the physician will state the risks that might come with the early release.

What should be included in this Authorization Letter?

  • Use of official letterhead of the clinic or hospital
  • Name of the doctor or physician who is treating the patient
  • Nam and complete address of the patient under treatment
  • Name of the parents of the patient (if he or she is minor)
  • Date on which the doctor is signing the release form
  • Date on which the patient was admitted
  • Details of the illness or medical condition of the patient
  • Details of how the doctor treated the patient
  • Clear consent of doctor or physician about the release of the patient
  • Reason to discharging the patient i.e. complete recovery, short leave for family emergency etc.
  • Any kind of risks that come with the premature release of the patient
  • Signature of the parents or guardian of the patient
  • Signature of authorized person i.e. doctor and admin of the hospital or clinic

Tips for Drafting a Release Authorization Letter:

  • When you are writing this authorization letter, make sure to use your official letterhead. This on one hand, makes it official and legal where on the other hand, this will also allow you to use it in any legal situation in your favor.
  • Start with including the name of the doctor(s) who are responsible for treating the patient in the hospital. Here you include their full name, their medical degree and designation in the medical facility i.e. doctor, general physician or surgeon.
  • Include complete details of the patient including his or her name, date on which he was admitted, his medical condition and previous medical history.
  • Then, add the statement or reason why you are going to release the patient. This can be because he is fully cured and ready to go home or if he or his family asked for early discharge due to some situation in family i.e. death or wedding.
  • Here the doctor will include precise statement about how he feels on the release of the patient i.e. if he is satisfied and agree with it or if he thinks this can lead to complications in the future.
  • If the patient is being released before his or her full recovery, the doctor should include a brief statement about how to take care of the patient and how to handle his medical condition at home.
  • Clearly mention the names of the parents of the patient or his guardian. This is the part where you will also mention the address where the patient will stay and if he is allowed to travel out of the state or country or not.
  • Ask the doctors and the parents of patient to sign the release form and if the patient is not minor, get his consent on the authorization form as well. This will mean that the patient clearly understands everything about his discharge.

Here is our collection of 46 Free Authorization Letter Samples & Templates,


Download Authorization Letter 01 


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Download Authorization Letter 46

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