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If you would like to authorize the transfer of your medical documents, here is a sample template you can use to write a medical authorization letter.


To

(Doctor’s name and address)

Date

Subject: Medical Authorization Letter

To Whomsoever It May Concern

I, (Your Name) hereby authorize (Your Current Doctor) to provide all my medical reports to (Your New Doctor’s Name). The reports will include every treatment that I have undergone from (Start Date) till (End-Date). I give my permission to the concerned doctor to use my reports to further treat my (Name of Illness).

If you have any questions, you can contact me at (Number).

Yours Sincerely,

(Name and Signature)