[Your letterhead, if desired; if not, your return address]
[Date of letter-month, day, and year]
[Recipient's first and last names]
[Street or P.O. box address]
[City, State ZIP code]
Dear [recipient's name]:
Thank you for providing quality care for my mother, Eleanor Atkins, at Sunrise Assisted Living. I hereby authorize you to provide her with insulin treatments for diabetes, on a daily basis and in consultation with Dr. Peter Williams.
Please always contact me before administering any medication or performing any medical treatment. I will authorize medical care as needed.
Thank you for your prompt attention to these important details.
[Sender's first and last names]