Doctors issue procedure consent forms to ensure that patients know the risks and benefits of a medical procedure. This is important because it allows patients to make an informed decision about whether or not they want to undergo treatment or testing. By signing the consent form, patients acknowledge that they understand the potential risks and benefits of the procedure and are giving their consent to proceed. It is vital for patients to sign procedure consent forms because it helps protect both the patient and the doctor. In doing this, the patient agrees to accept responsibility for any potential risks or complications arising from the procedure. We strongly recommend using our professional template to ensure you collect all the necessary data and consent from your patients.
What Is a Procedure Consent Form?
A Procedure Consent Form is a document used to obtain a patient’s informed consent before a medical procedure. The form outlines the details of the proposed treatment or test, including the risks and benefits, and allows the patient to decide whether or not to proceed with the procedure. The form also serves as a legal document that can be used in the event of a dispute or lawsuit.
When is a Procedure Consent Form Needed?
A procedure consent form is needed whenever a medical or scientific procedure is performed which involves risk or potential risk to the patient. In these cases, it is vital that the patient has given their informed consent to the procedure, and the consent form provides a written record of this agreement. Here are some examples of times when these forms are necessary.
- When getting anesthesia
- Before surgery
- If the patient needs a biopsy or advanced medical testing
- Before a blood transfusion
- Prior to starting chemotherapy
- Many blood tests, such as those for HIV and STD testing, require this form.
- When attending physical therapy
- Before receiving radiation
- Vaccinations require procedure consent forms.
Why Is a Procedure Consent Form Important?
Procedure consent forms are important for many different reasons. For example, consent forms are vital to the medical documentation process. Below we’ve listed additional reasons why these documents are so essential to collect before treating patients.
- They provide medical practitioners with legal protection against some forms of litigation.
- They serve as a record of informed consent.
- They help build trust between the medical community and patients.
- They provide the patient with a complete and transparent description or understanding of the procedure, including any risks and potential benefits associated with it.
- They should also outline any alternatives to the procedure, such as waiting and seeing if symptoms improve on their own or seeking a second opinion.
- They encourage open dialogue so the patient asks any questions they have
- They respect the patient’s right to bodily autonomy.
Essential Elements of a Procedure Consent Form
The essential elements of a procedure consent form are straightforward. These include patient information, such as their name and address, the doctor’s name, and statements showing the patient understands and consents to the treatment as described on the form. Below we’ve listed these in the order they normally appear on the document, with a brief explanation of the purpose of each part.
- (Optional but Recommended) Business Logo or Name- Most professional businesses use a logo or add their business name to the top of their forms for easy identification and better, more consistent branding.
- Title- The title of a document should always be the first thing you see. A large, bold-print title at the top of the form that says explicitly and precisely what the form is.
- (Optional) Read Statement- A statement is a strongly worded recommendation telling the patient to read everything carefully before signing a consent form.
- Client Name- List the patient’s full legal name to avoid confusion with other medical records.
- Client Contact Information- Leave space for the client to list their home address, phone number, and email here.
- Doctor’s Name- This is usually the primary care physician or other doctor recommending the procedure. However, it can also refer to the doctor performing the treatment or test if they are a specialist who was personally involved in or responsible for explaining the recommended treatment and why it is necessary or advisable.
- Statements of Understanding- The statements of understanding ask the patient to explain what condition they have that warrants treatment and the proposed treatment or test they are consenting to. Having them fill out this section shows that you have discussed the recommendations and medical necessity with your patient and respected their rights.
- Statements of Assent- The assent statements include everything your patient is agreeing to. These can consist of the treatment itself, that they’ve had an opportunity to ask questions, and other similar necessary consent statements.
- Signature and Date Lines- The signature and date lines are where the patient signs the form. These are necessary for it to be a legally binding document.
Pro Tip: Once you finish creating your form, don’t print it immediately. Instead, walk away from it for a while and come back to reread it. Alternatively, you could have someone else read the document back to you so you can hear how it sounds to your patients.
Tips for Creating a Better Procedure Consent Form
A basic procedure consent form is perfectly acceptable. However, using the tips below, you can quickly and easily modify your document to make it more complete, accessible, and valuable to the patient. Feel free to bookmark this page so you can refer to this section when making your consent form.
- Ensure that the language used in the form is clear and easy to understand. Most patients are not medical personnel and may need help understanding complex, industry-specific terms.
- Use a professionally designed template to save time.
- When applicable, include a brief aftercare section requiring the patient to agree to follow their doctor’s orders.
- Inform the patient of the duration of the procedure and any healing time.
- Let the patient know if they need to come back for follow-up appointments.
- Do a basic spelling and grammar check to catch any mistakes.
Patients and medical practitioners have many questions about consent forms. To help demystify these essential documents, we’ve answered some of the most frequently asked questions from people seeking more information on the topic.
You do need written consent to do a procedure on a patient. This is because the patient must be aware of the risks, benefits, and alternatives associated with the proposed treatment or test and must give informed consent for it to be performed. Written permission is also necessary in order to ensure that there is a legal record of the patient’s consent. Healthcare providers must ensure that patients have given their full informed consent before performing any procedure.
While it is typically recommended for the person administering the treatment to get consent, nurses can collect consent from patients for procedures and tests. In many cases, nurses are responsible for obtaining informed consent from patients before any medical procedure is performed because they are the ones who speak to them first. This includes getting the patient’s signature on a consent form that outlines the risks and benefits of the procedure. Nurses who collect consent from patients must also ensure that the patient understands the information provided and can make an informed decision about whether or not to proceed with the procedure. Sometimes, nurses, especially nurse practitioners, may also be responsible for providing additional information to the patient about the recommended procedure or test and answering any questions they may have.
If a medical procedure is performed on a patient without their consent, the doctor can face serious repercussions, including legal action taken by the patient. Depending on the severity of the situation and the details of the case, the doctor may face the consequences such as reprimanding or suspension, loss of professional privileges, or even criminal charges.
The doctor involved in performing an unauthorized medical procedure may also face a potential civil lawsuit; even if criminal charges are not filed, the doctor could be found liable for damages by civil courts. The patient could be awarded financial compensation for medical bills, pain and suffering, and other damages related to their experience.
A Procedure Consent Form is a legal document allowing individuals to provide informed consent before a medical procedure or other medical intervention. This form serves to protect both the patient and the healthcare provider. When it is necessary for a clinic, hospital, or other medical practitioners to obtain written permission from a patient before administering a medical treatment or procedure, they issue these crucial documents. Typically, this form will include the patient’s name, address, date of birth, and other demographic information; information about the procedure or medical intervention; risks and benefits of the procedure or test; and the patient’s consent. Choosing a professional procedure consent form template saves time and ensures that your patients know their rights and options and can provide informed consent.