Consent Letter Template

This consent letter template has 2 pages and is a MS Word file type listed under our business plan kit documents.

Sample of our consent letter template:

[DATE] [CONTACT NAME] [ADDRESS] [ADDRESS 2] [CITY, STATE/PROVINCE] [ZIP/POSTAL CODE] [YOUR NAME] [YOUR ADDRESS] [CITY, STATE, ZIP CODE] [YOUR EMAIL ADDRESS] [YOUR PHONE NUMBER] [DATE] SUBJECT: CONSENT LETTER Dear [RECIPIENT'S NAME], I, [YOUR NAME], the undersigned, hereby grant my consent for [RECIPIENT'S NAME] to [SPECIFY THE PURPOSE FOR WHICH CONSENT IS GIVEN, E.G., TRAVEL WITH MY CHILD, ACCESS MY MEDICAL RECORDS, USE MY PERSONAL INFORMATION, ETC.]. This letter is intended to formally acknowledge and provide clear consent for the aforementioned purpose. Details of Consent: Purpose of Consent: [EXPLAIN IN DETAIL THE PURPOSE FOR WHICH CONSENT IS GRANTED.] Recipient of Consent: [SPECIFY THE FULL NAME OF THE RECIPIENT WHO WILL RECEIVE THIS CONSENT.] Duration of Consent: [MENTION THE PERIOD FOR WHICH THIS CONSENT IS VALID, IF APPLICABLE. IF IT'S A ONE-TIME EVENT, YOU CAN INDICATE THAT.] Scope of Consent: [CLARIFY THE SPECIFIC ACTIONS OR ACTIVITIES FOR WHICH CONSENT IS GIVEN.] Conditions or Limitations: [INCLUDE ANY CONDITIONS OR LIMITATIONS, IF APPLICABLE, UNDER WHICH THE CONSENT IS GRANTED.]