Senior Citizen Medical Authorization Letter

June 12, 2050

Mary Whitehead

4876 Elk City Road

Indianapolis, IN 46204

Dear Ms. Whitehead,

I, Timothy Peters, hereby authorize you as a trustworthy and responsible person to make the necessary medical decisions on my behalf in the scenario where I am incapacitated or unable to make decisions independently. The decisions include, but are not limited to planning, execution and monitoring of treatment requirements as outlined by clinical professionals.

This authorization is in effect until further written notice from my end. Your adherence and understanding towards my health decisions and requests will be highly appreciated, considering both our best interests.

Yours Sincerely,

Timothy Peters