Hospital authorization

Within the scope of the legitimate rights and interests authorized by the client, the client shall not go back on the entrusted matters for any reason. With the continuous progress of society, we will use power of attorney in many affairs, but we have no clue when writing power of attorney? The following is my collection of hospital power of attorney, hoping to help everyone.

Power of Attorney of the Hospital 1 I hereby entrust the staff of our hospital (company) with the ID number: the person who picks up and receives goods for our hospital (company) and is responsible for receiving medicines.

Authorization period: 20xx11October to 20xx1February 3 1.

Entrusting unit:

Legal Representative (signature and seal):

Date of entrustment: year month day.

Copy of ID card (front and back) paste:

Power of Attorney of the Hospital 2 This is because the patient is seriously ill due to work and has a long journey abroad.

I really can't apply for medical records in person, so I hereby entrust you to apply to your hospital on your behalf. The scope of the application materials is:

For its use.

Zhi Zhi Hospital

Client: (signature) ID number:

Household registration:

Trustee: ID number:

Household registration:

Telephone:

Date, year and month

Copy of customer certificate

Copy of trustee's certificate

Hospital power of attorney 3 Patient name: XXX；; Gender: x; Age: x; Medical record number: XXX

Client (patient himself): Age

Trustee: Age Tel: Relationship with patient: □ spouse □ children □ parents □ other close relatives.

□ Colleagues □ Friends □ Others

I was hospitalized because of illness. During my hospitalization, I solemnly entrust you as my agent to exercise my right of informed consent during my hospitalization and perform the corresponding signing procedures. The signature of the authorized representative shall be deemed as my signature.

After the client signs the consent form, the consequences will be borne by the patient himself.

Signature of patient: (handprint) MM DD YY.

Signature of the trustee: (handprint) MM DD YY.

The power of attorney of the Fourth Academy hereby entrusts ××× (name, gender, age and position) to act as the agent of ××× (project name) on behalf of the enterprise, and its authority is as follows:

××× (specify the matters and contents of agency, including the right to negotiate, the right to sign contracts, and the right to admit or waive certain rights on behalf of others)

Legal Representative: ××××××

X year x month x day

Further reading: demolition entrustment contract

How to write the lease entrustment contract

Entrustment contract of residential area

Property management entrustment contract

explain

The power of attorney of the legal representative is a legal document that an enterprise as a legal person entrusts others to act as an agent for a certain legal act. If the legal representative is unable to exercise his functions and powers in person for some reason, he may entrust others to exercise his functions and powers on his behalf. At this time, it is necessary to make a power of attorney of the legal representative, and the client carries out activities within the scope of authorization, which has direct legal effect on the client.

Matters needing attention in filling in the power of attorney of the legal representative are as follows: Basic information such as the client's name, gender, age and position must be stated. To define the scope of authorization, we should not simply write "full authorization", but define the contents of authorization item by item. If the litigation is entrusted by an agent, the authority of the entrusted agent in the litigation process, the right to give up and admit the litigation request, the right to counterclaim, the right to reconciliation, etc. It should be clear. If it is not specified, it is considered that it does not have these specific rights, but only has the right to appeal. If a contract is signed, it should be clear under what conditions and within what scope the contract is valid, and beyond this scope it is invalid.

Hospital power of attorney 5 entrusts our hospital, ID number:, responsible for our online drug procurement and other related work in your company.

Validity period: from year to year.

Copy of legal person's ID card, copy of agent's ID card.

Xxxx hospital

Xx，xx，XX，XX

Hospital power of attorney 6 power of attorney

The patient _ _ _ _ _ _ _ _ _ _ _ _ _ is a very special person.

Zhi Zhi Hospital

Trustee: ID number: Tel:

Customer: ID number: Tel:

date month year

Hospital Power of Attorney 7 Department: XXX

Bed number: XXX

Hospitalization number: XXX

Patient name: XX

Gender: XXX

Age: XX years old

Because I came to the hospital for diagnosis and treatment, I agreed to accept the doctor's suggestion of "hospitalization for further diagnosis and treatment" according to my diagnosis and treatment situation and health status. During my stay in hospital, I entrusted all my medical affairs and related matters, and the scope of authorization was as follows:

1. Truthfully provide the hospital with all the true information about my illness, accept the hospital's inquiries and answers, assist in diagnosis and treatment, accept the doctor's inquiries and sign relevant documents.

2. To understand my illness, authorize me to choose or agree to the diagnosis and treatment plan when I can't make a decision alone.

3. When the patient is incapacitated, the patient's legal representative shall perform his legal rights and obligations on his behalf.

4. The patient's guardian or agent should visit or accompany the patient regularly, understand the condition, pay medical expenses, agree or refuse to use self-funded and expensive drugs or diagnosis and treatment measures, agree or refuse to inject blood and blood products, agree or refuse the operation plan, agree or refuse various medical measures in rescue or operation, and handle other affairs related to the patient. The affairs handled by the agent within the scope of authorization and the medical risks caused by the agent's failure or delay in performing the agency affairs shall be borne by the agent and himself, and have nothing to do with the hospital.

Meanwhile, my client and I promise as follows:

During hospitalization, if the patient leaves the ward without authorization, and there are consequences such as aggravation, deterioration, complications, sudden death, self-injury, suicide, loss, personal injury, attack, accident, and inability to reimburse hospitalization expenses due to leaving the hospital without authorization, the patient shall bear the responsibility himself.

This power of attorney and commitment shall be valid from the date of admission to the date of discharge.

I made the above commitment voluntarily under the condition of completely free choice of hospital.

Patient's signature (handprint): XXXX

Id number: XXXX

Address: XXXX

Tel: XXXXX

Date of signature: XXXX year x month x day x hour x minute.

Signature of agent (handprint): XXXX

Id number: XXX

Address: XXXX

Tel: XXX

Relationship with patients: XXXXXX

Date of signature: XXXX year x month x day x hour x minute.

Power of attorney for bed 8 in the hospital department _ _ _ Hospitalization number: _ _ Patient name: _ _ _ Gender: _ _ _ Age _ _ _ _ _,

Because I came to the hospital for treatment, I agreed to accept the doctor's suggestion of "hospitalization for further treatment" according to my diagnosis and treatment and health status.

During my hospitalization, I entrusted _ _ _ _ to take charge of all my medical affairs and related matters, and the scope of authorization is as follows:

1. Truthfully provide the hospital with all the true information about my illness, accept the hospital's inquiries and answers, assist in diagnosis and treatment, accept the doctor's inquiries and sign relevant documents.

2. To understand my illness, authorize me to choose or agree to the diagnosis and treatment plan when I can't make a decision alone.

3. When the patient is incapacitated, the patient's legal representative shall perform his legal rights and obligations on his behalf.

4. The patient's guardian or agent should visit or accompany the patient regularly, understand the condition, pay medical expenses, agree or refuse to use self-funded and expensive drugs or diagnosis and treatment measures, agree or refuse to inject blood and blood products, agree or refuse the operation plan, agree or refuse various medical measures in rescue or operation, and handle other affairs related to the patient. The affairs handled by the agent within the scope of authorization and the medical risks caused by the agent's failure or delay in performing the agency affairs shall be borne by the agent and the agent, and have nothing to do with the hospital.

Meanwhile, my client and I promise as follows:

During hospitalization, if the patient leaves the ward without authorization, and there are consequences such as aggravation, deterioration, complications, sudden death, self-injury, suicide, loss, personal injury, attack, accident, and inability to reimburse hospitalization expenses due to leaving the hospital without authorization, the patient shall bear the responsibility himself.

This power of attorney and commitment shall be valid from the date of admission to the date of discharge.

I made the above commitment voluntarily under the condition of completely free choice of hospital.

Patient's signature (handprint): _ _ _ ID number: _ _ _ Address: _ _ _ _

Tel: _ _ _ _

Date of signing: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Signature (handprint) of agent: _ _ _ ID number: _ _ _ Address: _ _ _ _

Tel: _ _ _ Relationship with patients: _ _ _

Date of signing: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Hospital power of attorney 9 Client (patient himself): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Valid ID number: _ _ _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Trustee: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Valid ID number: _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ Relationship with patients: □ spouse □ children □ parents □ other close relatives □ colleagues □ friends □

Other _ _ _ _ _ _ _ _ _ _ _ _

I was hospitalized on _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. During my hospitalization, I solemnly entrusted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

After the client signs the consent form, the consequences will be borne by the patient himself.

Patient's signature: _ _ _ _ _ _ _ _ _ _ (handprint)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Signature of the trustee: _ _ _ _ _ _ _ _ _ _ _ (handprint)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Power of Attorney of Hospital10 _ _ _ _ _ _ _ (name of the tenderer):

_ _ _ _ _ _ _ _ _ _ _ (full name of the bidder) Authorized by the legal representative _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Hereby entrust.

Signature of legal representative: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (official seal of legal person)

Name (official seal) of the bidder: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Date: Year Month Day

Attachment: Name of Bidder's Representative: _ _ _ _ _ _ _ _ _ _ _ _ _ _ (printed and signed)

Job title: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ID number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Detailed mailing address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Postal code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Fax: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Tel: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Hospital power of attorney 1 1 client (patient himself): XXXXX

Gender: XXXX

Age: XXX

Valid ID number: XXXX

Address: XXXXX

Trustee: XXXX

Gender XXX

Age XXX

Tel: XXXX

Valid ID number: XXXX

Address: XXX

Relationship with patients: □ spouse □ children □ parents □ other close relatives □ colleagues □ friends □ others.

I was hospitalized due to illness in XXXX. During hospitalization, I solemnly entrust you as my agent to exercise the right of informed consent during hospitalization and perform the corresponding signing procedures. The signature of the authorized representative shall be deemed as my signature.

After the client signs the consent form, the consequences will be borne by the patient himself.

Patient's signature: XXX (handprint)

XXXX year x month x day

Signature of trustee: XXXX (handprint)

XXXX year x month x day

Power of Attorney of the Hospital 12 According to Article 56 of Chapter 7 of the Tort Liability Law of People's Republic of China (PRC), "If the opinions of patients or their close relatives cannot be obtained due to emergency situations such as saving dying patients, the corresponding medical measures can be implemented immediately with the approval of the person in charge of the medical institution or its authorized person in charge" and Article 10 of the Basic Norms for Medical Record Writing "......................................................

Client: xxx

Gender: female;

Ethnic group: Han nationality

Position: hospital president, legal representative

Trustee:

1, vice president of business, cadre of medical department.

2, the hospital always on duty

Authorized items:

In emergency situations such as rescuing dying patients, if the opinions of the patients or their close relatives cannot be obtained, the trustee shall exercise the approval right of the person in charge of the medical institution and immediately implement corresponding medical measures for the patients.

Duration of authorization: long term.

Customer:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Power of Attorney of Hospital 13 Client (Patient): Gender and Age

Valid ID number: Address:

Trustee: gender, age and telephone number:

Valid ID number: Address: Relationship with patients: □ spouse □ children □ parents □ other close relatives □ colleagues □ friends □

I was hospitalized because of illness. During my stay in hospital, I reported illness.

And all the informed consent forms that need to be signed in the process of diagnosis and treatment, I solemnly entrust my agent to exercise the right of informed consent during hospitalization and perform the corresponding signing procedures.

The signature of the plenipotentiary shall be deemed as my signature.

The consequences after the client signs the consent form shall be borne by the patient himself.

Patient's signature: (handprint) MM DD YY.

Signature of the trustee: (handprint) MM DD YY.

Power of attorney of the hospital 14 from _ _ _ _ _ _ _ _

Zhi Zhi Hospital

Trustee: _ _ _ _ _ _ _ _ _

ID number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Phone number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Client: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ID number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Phone number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Hospital power of attorney 15, please read the instructions on the back of this page carefully and fill in, and bring all necessary documents and certificates for approval.

Power of attorney for copying medical records

Rongjiang County Hospital of Traditional Chinese Medicine:

I hereby authorize (mine) to copy my medical record and hospitalization number in your hospital. Please deal with it, and I will be responsible for all the consequences.

Customer's signature:

Customer's ID number: