[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Recipient's Name] [Recipient's Title] [Medical Facility Name] [Medical Facility Address] [City, State, ZIP] Subject: Medical Consent Letter — Request for Consent and Enclosed Consent Form Dear [Recipient's Name], I hope this letter finds you in good health and high spirits. I am writing to request your kind assistance in granting medical consent for [Patient's Name], my [relationship to patient] who is under [his/her] care at your esteemed medical facility. As [Patient's Name]'s [relationship to patient], it is my utmost responsibility to ensure that [he/she] receives proper medical attention and treatment whenever necessary. In this regard, it is crucial for me to have the legal authority to provide consent for medical procedures, treatments, surgeries, and medications on behalf of [Patient's Name], especially during situations that necessitate immediate medical attention. Enclosed with this letter, please find the Rhode Island Medical Consent Form, which I kindly request you to review and duly complete. This form acknowledges your agreement to grant me, [Your Name], the necessary medical consent authority on behalf of [Patient's Name]. I have completed all my sections and provided accurate information accordingly. The enclosed Rhode Island Medical Consent Form covers various possible scenarios that may require medical intervention for [Patient's Name], including emergency medical treatments, surgical procedures, administration of medications, medical consultations, and any other treatments deemed necessary for [his/her] wellbeing. Kindly verify the enclosed form, making any additional changes or suggestions as you deem appropriate. I understand that ensuring proper documentation is essential for the smooth facilitation of medical care for [Patient's Name]. Therefore, I kindly request your cooperation in signing and returning the completed Rhode Island Medical Consent Form at your earliest convenience. Should you have any questions or require further information, please do not hesitate to contact me via phone or email. I appreciate your prompt attention to this matter, as it is vital for my assurance and [Patient's Name]'s continued well-being. Thank you in advance for your cooperation and assistance in handling this matter with utmost importance. I sincerely value the dedication and professionalism of [Medical Facility Name] and trust that our shared commitment will result in the best possible care for [Patient's Name]. Yours sincerely, [Your Name]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.