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 MEDICINES
REQUIREMENTS
OWNER:
- Original Valid IDs.
- Signed Authorization Letter for when buying medicines.
- Doctor’s Prescription.
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.
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.
[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]
