I, [Family Representative Name], hereby authorize representatives of DOSA Foundation to assist my family during this difficult time. The assistance requested includes, but is not limited to, the following:

Medical Support

Assistance in accessing medical care, arranging medical services, and coordinating with hospital physicians.

Legal Assistance

Help with legal documentation, including obtaining death certificates, release forms, and other necessary paperwork.

Coordination with Authorities

Medical Examiner’s Office: Coordination to obtain necessary documents or information and expediting the repatriation process

Law Enforcement: Assistance in managing any required interactions or documentation with law enforcement agencies.

Hospital Physicians: Liaising with medical staff to manage medical records, discharge papers, or other related documentation.

Full Power Authorization

I grant DOSA Foundation full authority to act on behalf of my family in coordinating and facilitating the above services, including making necessary decisions in urgent situations.

Signature of Authorization

I understand that representatives of DOSA Foundation will use this authorization solely to provide the assistance requested. All information will be kept confidential.