Make a Free Medical Consent

A medical consent form is used to obtain medical consent for certain treatment or medical procedure.

Create Now

How It Works

Create a Medical Consent in less than 5 minutes

Legally binding in all 50 states

Print and export to Word or PDF in seconds

Sample Medical Consent

Read Full Document

Sample Medical Consent

Create Medical Consent

Medical Consent: What Is It?

A medical consent form is used to obtain medical consent for certain treatment or medical procedure. Medical consent is typically given by the patient, as long as they are of consenting age. For children, consent is given by their parent or guardian. People who cannot speak for themselves but need medical care may have consent given by a spouse or other family member.

A medical consent form should include information about the patient and details about the medical treatment or procedure being performed. This ensures that the patient or patient representative can make an informed consent decision. The patient or representative should then sign the form, and a copy should be kept by both parties.

Click here to get started now!

Contents of a Medical Consent Form

contents of a medical consent form

A medical consent form is exactly what it sounds like. It functions as a waiver for anyone undergoing a potentially risky medical procedure. It confirms that the patient and/or caregiver understands the medical risks at hand, while rendering the medical institution liability-free.

Medical consent forms are easy to draw up, especially if you already have a bare-bones version in place. In the following article, we'll go over the major components you'll need to create a medical consent form template.

A medical consent form must perform three functions:

1.) Summarize the nature and purpose of the procedure.

This can be brief, and should stand out on the page. Consider making it bold and putting a nice tidy box around it. For example -

Knee-replacement is a surgical procedure to relieve disability or pain in, and improve/sustain motility of, the knee. It involves partial or total replacement of damaged and/or diseased weight-bearing parts in the knee-joint with plastic and/or metal components.

2.) Provide an overview of risks and alternatives, and state that all risks, as well as any possible alternatives, have been explained to the patient/caregiver.

This section must summarize risks particular to the procedure and to the type of process in general, For example, a consent form for knee surgery should include something like this -

I understand that possible risks of knee surgery include damages incurred to the leg and surrounding area.

as well as something like this -

I understand that possible risks of invasive procedures include infection, bleeding, paralysis, stroke, permanent injury and death.

A good way to handle medical alternatives is to include a "fill-in clause," such as -

Possible alternatives to knee surgery include _________.

This section should also include explicit statements that the purpose of the surgery, as well as all risks, have been explained to the patient/caregiver. For example -

The purpose and nature of this procedure have been explained to me. I have also been informed of all medically significant risks of the aforementioned procedure. I am aware that no guarantee can be made regarding the outcome of the aforementioned procedure. All reasonable alternative treatments, including consequences and medically significant risks, have also been explained to me. I have also been made aware of the risks and consequences of no treatment.

If you want to be really thorough (which you should), you can throw in a little quiz section at the end. Questions can look something like the following -

The benefits of knee replacement surgery include _______.

One of the risks of knee replacement surgery is _________.

This will ensure that the patient/guardian is on exactly the same page.

3.) Function as a waiver.

In this last section, the patient/guardian must provide his or her legal consent. The patient's full legal name must be provided, along with the name of the procedure and the full legal name of the physician and institution. For example -

I authorize Dr.(s) __________ and/or other physicians he/she deems qualified to perform a ___________ on ________________.

This section should consist of an itemized list of consents , with the above statement modified to fit all of the following that apply -

  • the procedure itself

  • the administration of anesthesia

  • the possibility of bloodwork

  • adoption by the medical institution of any removed body parts and/or use of said parts/the procedure for medical research

  • additional procedures deemed advisable by the physician, in the case of unanticipated conditions revealed during the procedure

The form should end with the dated signatures of the patient/guardian, the doctor, and a witness. If the patient does have a guardian, the guardian's relationship to the patient must be noted. In the case of a language barrier, this part must also include the dated signature of the patient/guardian's interpreter.

Download a PDF or Word Template

Medical Consent

Medical consent is a form that is used by a parent or guardian to give permission to another person or health facility to provide medical treatment for their child or ward. A medical consent form is a necessity if the child is traveling with someone who is not their legal guardian and cannot make medical decisions.

Read More

Living Will

A living will is a necessity for every adult. The purpose of a living will is to give you a way to express your wishes for medical care in the event that you are no longer able to voice those wishes on your own.

Read More

Affidavit of Death

When someone dies, the person who is named as the executor may create an affidavit of death. An affidavit of death is a sworn statement that the person named is deceased.

Read More

Guardianship Forms

Guardianship is legal protection for a care provider who has responsibility for a child or vulnerable adult.

Read More