[Your Name] [Your Address] [City, State, Zip] [Email Address] [Phone Number] [Date] [Recipient's Name] [Recipient's Address] [City, State, Zip] Subject: Consent for Medical Treatment — Enclosed Form Dear [Recipient's Name], I hope this letter finds you in good health and high spirits. I am writing to provide my full consent and authorization for [Patient's Full Name], my [relationship], to receive necessary medical treatment. Enclosed with this letter, you will find the completed Medical Consent Form, which authorizes medical professionals to provide necessary care to [Patient's Full Name]. [Patient's Full Name] is a resident of San Diego, California, a vibrant coastal city known for its beautiful beaches, Mediterranean climate, and diverse cultural attractions. San Diego offers a plethora of world-class medical facilities and highly skilled healthcare professionals, making it an ideal location for medical treatment. In light of [Patient's Full Name]'s medical condition and the recommendations provided by his/her healthcare team, it is imperative to promptly initiate the required treatment. As [Patient's Full Name]'s [relationship], it is my responsibility to ensure his/her well-being and access to appropriate medical care. This Medical Consent Form is intended to grant permission for medical professionals to administer all necessary examinations, tests, procedures, medications, or surgeries that are deemed essential for [Patient's Full Name]'s diagnosis, treatment, and recovery. I have carefully reviewed the form, filled it out accurately, and provided all relevant medical information required for a comprehensive assessment. Should unforeseen circumstances arise during the medical treatment, I authorize healthcare providers to make any reasonable and necessary decisions on behalf of [Patient's Full Name] to protect his/her health and well-being. These decisions may include, but are not limited to, diagnostic tests, adjustments to treatment plans, or referrals to other specialists when deemed appropriate. I understand that providing consent does not absolve me from any financial responsibilities associated with the medical treatment. I acknowledge that I am responsible for all costs incurred during [Patient's Full Name]'s care and treatment. Furthermore, I am fully aware of the potential risks, benefits, and alternative treatments associated with the recommended medical procedures. Enclosed with this letter, you will find the original copy of the completed Medical Consent Form along with any necessary supporting documentation. Kindly review the provided documents and acknowledge your receipt by signing the enclosed form. Your prompt attention to this matter is sincerely appreciated, as it will enable us to initiate the necessary medical treatment for [Patient's Full Name]. I trust in your expertise and commitment to delivering the highest standard of care. If you require any additional information or have any questions, please do not hesitate to contact me at [Phone Number] or [Email Address]. Thank you for your understanding, cooperation, and dedication to [Patient's Full Name]'s well-being. 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.