January 3, 2012
To whom it may concern:
I am Julianna Manansala, mother of Joaquin Manansala, 3 years old would like to authorize Ms. Roxanne Guinoo to perform any acts related to my son’s health while I am away. I want to ensure that my health of my son will be in good hands. This includes any doctor or hospital visits, medicines, vaccines or surgeries.
This authorization shall be valid between the dates of January 05 to February 25, 2012 while I am away from home. Ms. Guinoo will bring medical records of Joaquin during his check up for your further reference.
Thank you very much for understanding and assistance concerning this matter.
Very truly yours,
Jualianna Manansala