Power of Attorney Letter From Doctor Example [Edit & Download]
I, Dr. Amanda Williams, residing at 456 Elm Street, San Francisco, CA 94101, hereby grant full authority to my designated representative, John Carter, residing at 123 Pine Avenue, San Francisco, CA 94102, to act on my behalf in matters related to my medical practice, patient care, and administrative responsibilities as specified below.
Powers Granted
- Patient Communication and Care:
To communicate with patients or their representatives regarding appointments, treatment plans, and follow-ups in my absence. However, this authority does not extend to making medical diagnoses or treatment decisions. - Administrative Management:
To manage administrative responsibilities, including scheduling appointments, billing, and handling correspondence related to my medical practice. - Legal Representation:
To act on my behalf in all legal matters related to my medical practice, including responding to legal notices, representing me in legal disputes, or providing necessary documentation to authorities. - Financial Transactions:
To handle financial transactions related to the medical practice, including paying rent for the clinic, utility bills, and managing accounts related to operational costs. - Prescription and Supplies Management:
To procure medical supplies, manage prescription inventory, and ensure that the clinic operates smoothly during my absence. - Insurance and Compliance:
To liaise with insurance companies and ensure compliance with all medical regulations and policies required for the clinic’s operation.
Effective Date and Duration
This Power of Attorney shall become effective on January 10, 2025, and will remain in effect until revoked by me in writing or until a specified period or event, whichever occurs first.
Revocation
This Power of Attorney may be revoked by me at any time by providing written notice to John Carter. Any such revocation shall be effective immediately upon the delivery of the written notice.
I affirm that this Power of Attorney is granted to ensure the seamless management of my medical practice in my absence, and I trust John Carter to act in good faith and in the best interest of my patients and practice at all times.
Signed on January 10, 2025, at San Francisco, CA.
Signature: Dr. Amanda Williams
Printed Name: Dr. Amanda Williams
Witness: Sarah Johnson
Witness: Emily Brown
[Notary Public Section as required in your jurisdiction]