Authorization Letter When Buying Medicines

Some pharmacies are looking for authorization letter when you are buying medicines, especially if the medicine is antibiotics or if you cannot buy because of your condition. This sample letter will help you with the right format of the letter when you buy medicine. But do not forget to change the details and medicines that you want to buy.

Authorization-Letter-When-Buying-Medicine

AUTHORIZATION LETTER WHEN BUYING MEDICINES

REQUIREMENTS

OWNER:

  • Original Valid IDs.
  • Signed Authorization Letter for when buying medicines.
  • Doctor’s Prescription.
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AUTHORIZED REPRESENTATIVE:

  • Original valid IDs for the representative.
  • Doctor’s Prescription from the owner.
  • Black Pen.

SAMPLE

October 1, 2020

Dear Pharmacist,

I authorize my daughter, Samanta D. Asis, to buy my medicines because I can’t go there personally because of my condition. I need to buy these medicines as prescribed by my doctor.

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Losartan 50mg — 20 pcs.

Prednisone 10mg — 20 pcs.

Co-Trimoxazole 80/400mg — 15 pcs.

Thank you!

Attached are my doctors’ prescription, Purchase Booklet, and my Senior Citizen’s card.

Respectfully Yours,
-signature-
Manilyn D. Asis




FORMAT

[DATE]

Dear Pharmacist,

I authorize my [FAMILY/RELATIVES], [BEARER’S NAME], to buy my medicines because I can’t go there personally because of my condition. I need to buy these medicines as prescribed by my doctor.

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[NAME OF MEDICINE] [DOSAGE] — [QUANTITY]

[NAME OF MEDICINE] [DOSAGE] — [QUANTITY]

[NAME OF MEDICINE] [DOSAGE] — [QUANTITY]

Thank you!

Attached are my doctors’ prescription, Purchase Booklet, and my Senior Citizen’s card.

Respectfully Yours,
[SIGNATURE]
[YOUR NAME]

Authorization Letter When Buying Medicine Sample

DOWNLOADABLE FILE: click here

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