Medical Liability Waiver Form

A medical liability waiver form is completed by medical professionals. It is used to get consent to treat a patient while also protecting themselves from liability if the patient is hurt or dies while in their care. This waiver generally also provides the patient of their privacy and legal rights. In order for this form to become legally binding, it must be signed by the patient or their legal representative.

What is a Medical Waiver form?

A medical liability waiver is document used by medical professionals to gain consent to treat a patient.  A medical liability waiver also serves to protect doctors and hospitals from liability if a patient is injured or dies while they are receiving medical treatment.  A patient may need to sign a waiver every time they are treated, or they may be able to sign one waiver that is valid for a specific amount of time.

Medical liability forms contain information about the patient's responsibilities regarding treatment, the patient’s privacy and legal rights, and the liability of the hospital or medical providers.  The waiver must be signed and dated by the patient, or their parent/guardian, spouse, or other legal representative.

Other names

  • Liability Waiver
  • Medical Liability Release Form
  • Medical Release and Liability Waiver
  • Release of Liability
  • Waiver of Liability

When to use a medical liability waiver

A medical liability waiver is important to protect you and your business or organization in case an unfortunate accident occurs while a patient is receiving treatment.

You should have a medical liability waiver if you are a medical professional or organization that is providing treatment to patients.

Components of a medical liability waiver form

To create a medical liability waiver you will need:

  • Your contact information - address, contact numbers
  • Dispute resolution details - whether you want mediation, arbitration, or mediation and then arbitration
  • Patient’s contact information - address, home phone (you can leave a space for them to fill out their information)
  • Patient’s emergency contact information (you can leave space for them to fill out)
  • Important medical information - information that a patient needs to know regarding their treatment

You may also want to collect: health insurance information (insurance company, insurance plan, policy number, and policy holder), medical condition information (chronic diseases), social security number, basic medical history.

Sample medical waivers are available online for your convenience.

Common situations for liability waivers

A medical liability waiver is necessary any time you provide any medical treatment.  It is also recommended for anyone who provides medical spa services.

Legal Considerations

A medical waiver will not protect you from your own negligence.  If you commit medical malpractice, a medical release form does not absolve you of responsibility.  However, if you treated your patient with the level of care that a reasonably competent and skilled medical professional in the same medical community would have provided in the same circumstances, a waiver will protect you from litigation if a patient is injured or dies.

Download a PDF or Word Template

Medical Liability Waiver Form

Release Of Liability

Power Of Attorney

Sample Medical Liability Waiver Form


Sample Medical Liability Waiver Form

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