Medical Power of Attorney. An employee is permitted to use sick days when they are the primary care giver and medical power of attorney for an ill family member. The district may request verification of the medical power of attorney. This relationship does not fall under current FMLA guidelines.
Medical Power of Attorney. I , , SSN , now serving as a member or spouse accompanying the US Forces Japan, do make, constitute, and appoint CADENCE STUDENTMINISTRIES STAFF AND ITS APPROVED ADULT VOLUNTEERS my true and lawful attorney-in-fact to dental, hospital care and treatment, either preventive or corrective, including major surgery deemed necessary by a duly licensed physician or dentist for the health and well-being of my child. Printed Name of Child Date of Birth If Civilian: Insurance Company: Policy Number: GIVING AND GRANTING unto said attorney full power and authority to do and perform every act, deed, matter and thing necessary, desirable, or expedient to accomplish any of the specifically enumerated purposes, lawfully done pursuant to the authority herein above conferred. However, all business transacted here under on my account shall be transacted in my name, and all endorsements and instruments executed by my account for the purpose of carrying out the above xxxxxx shall contain my name, followed by that of my attorney and the designation of “attorney-in-fact.” Any lawfully done here under my said attorney shall be binding on myself and my heirs, representatives, and assigns. Unless sooner revolved or terminated by me, this Medical Power of Attorney shall become Null or Void after 12/31/2019. Printed Name of Parent/Guardian Signature of Parent/Guardian Date Home Phone # of Parent/Guardian Cell Phone Work Phone Printed Name of Witness Signature of Witness Date
