This type of authorization letter would be addressed to the concerned medical authorities in relation to disclosure of any medical information. This would signify the detailed disclosure, consent on terms & conditions & related factors briefed up.
Mr. Sahil Kulkarni.
Wockhardt Intensive Unit.
Human Resource Department.
5th Sept’ 2010.
Subject: Authorization Letter on medical terms & grounds.
Dear Mr. Sahil;
With reference to the disclosure notifications on medical terms dated 25th Aug’ 2010. by the intensive unit; I the undersigned employee from general ward section of your esteemed intensive unit would like to hereby consent & authorize to make use of & disclose the personal medical information as may be required as per the notifications announced. Further I am also ready to do the needful to update the medical information & also take necessary efforts to contribute in the task to make it possible in a convenient way.
Further having taken advantage of the medical campaign organized a week before; thereby enclosing the medical report recently diagnosed by the doctor prescribed by the intensive unit. Kindly acquaint us the course of action to complete the authorization formality and if any other documents also need to be submitted.
Mr. Akshay Purohit.