THIS IS NOT AN ATTORNEY SERVICE! THIS IS A DOCUMENT DRAFTING SERVICE.
IF YOU REQUIRE LEGAL REVIEW OR REPRESENTATION YOU SHOULD ALWAYS
CONSULT AN ATTORNEY.
Organ Donation Directive Use this form to state your intent to donate organs and tissues. You may also
instruct that your donation be used for such purposes as transplantation, education, or research • Written documentation to help assure
that your wishes are honored • Specify which organs may, or may not, be donated • Specify a certain person to receive your organ donation
Medical
Records Request Use this document to produce a letter and an authorization form to request a patient's medical records from a
health care provider • A change in doctors • Moved to a new location • New or different health care provider
Request for Referral
to Medical Specialist This letter can be used to request a referral to a specialist for medical care • To request a referral
to a specialist when your insurance company or managed care organization requires a referral from your primary care physician • To
request a referral to a specialist when the specialist will not see you without a referral from your primary care physician • To indicate
which specialist you would like to see
Response to Denial of Medical Benefits This letter is used to appeal a denial of a medical
claim by a managed care organization (such as a HMO) or an insurance company or to seek more information about a denial • To request
an explanation for, or more information about the denial of a claim • To provide information regarding why a denial should be reversed• To request that your physician write a letter explaining why health care services were medically necessary
Authorization for
Medical Treatment of Minor This authorization is used by a parent to authorize a child care provider, parent, or other responsible
person to obtain medical treatment for a child • To grant medical authorization to a person having temporary responsibility for your
child • To state the amount of authorization and to provide medical and contact information
Please Call Steve on (509) 389 4804 for
a free consulation and to answer your initial questions on any of these documents
Medical Documents
(509) 389 4804
