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Archive for the ‘Authorization Letter’ Category

   

March 11, 2010
ZZZ Hospital
Alabama Street

To Whom It May Concern:

I, Wendy White, hereby authorize ABC Hospital to release to Michelle Henderson, my personal records, and as well as my laboratory information that has connection with my previous hospitalization.

I will use the medical records to assists the hospital and the medical doctors to diagnose my health problem. I am hoping for a fast response with regards to this request.

Respectfully,
(Signed)
Wendy White

December 3, 2009

Arkansas Realty

To Whom It May Concern:

I Richard Henderson is currently in Japan and unable to go there and present my request to change the billing statement to be in my name. For this reason, I hereby authorize my father, Patrick Henderson to be my representative in all matters in accordance to my newly bought home in Washington, including the signing of documents relating to this matter.

I am enclosing a copy of my company ID and my voter’s ID for your further reference.

If you have any questions regarding this matter, please feel free to call me in my telephone at (123) 222-2222.

Thanking you in anticipation.

Sincerely,

(Signature)

Richard Henderson

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