Medical Consent Form Template

What is a Medical Consent Form?

Ensuring your patients provide informed consent for any proposed tests or procedures is a crucial part of maintaining ethical and .

Informed consent means that the clinician has informed the patient of the risks and benefits of the procedure they are consenting to. This means they have been given a balanced and unbiased view of the procedure, and are aware of the potential negative side effects or complications they risk by consenting.

A medical consent form, or a  signed by their legal guardian, is a legal document to declare in writing that the patient or their guardian has been informed of the likely risks and benefits of undergoing this procedure and that they wish to go ahead.

A medical consent form needs to include a few things. These include the patient or their representative’s name and signature, the date, the procedure or test for which they are consenting, and any other important details like the practitioner’s name or the relevant hospital department.

How to Use this Medical Consent Form

The first step to obtaining informed consent is initiating a discussion of the potential risks and benefits of the procedure in question. For example, if the patient is to be treated with radiation, they should be informed of the known short-term and long-term side effects as well as the potential benefit of shrinking their tumor. The patient should be able to ask any questions they have regarding the procedure as part of this discussion.

Once the patient or their legal guardian is satisfied they understand the potential risks and benefits of the procedure, they can begin the medical consent form.

1. Fill in the Patient Information

The first step is to fill in the patient's name, the date, and identifying information such as date of birth, gender, and identifying number if used.

2. Fill in the referring physician section

This section includes a space for the name of the referring physician, the recommended treatment/procedure, the patient’s condition, and the discussed risks and complications. The clinician obtaining the consent should then fill in their name, designation, and signature at the bottom of this section.

3. Patient to read through the form and ensure they understand what they are signing.

The patient should read the Authorization and Consent section of the form carefully and make sure they agree with each of the statements.

4. Patient and/or representative to sign 

If they are happy to proceed, the patient and/or their representative should sign the medical consent form and fill in the date. 

5. Store the record securely

The signed medical consent form is a very important legal document that you are legally required to store securely. This document may need to be accessed by other members of your patient’s care team in the future, so it should also be stored somewhere it can be easily accessed by others who may need it.

Medical Consent Form Example

This consent form includes a lot of details and information, so to help you understand what belongs where- we have produced a completed example. This example involves a patient consenting to a sentinel lymph node biopsy.

Check out and download the Medical Consent Form Example here:

Who Can Use this Medical Consent Form?

Informed consent can only be given by adults capable of understanding and weighing the risks and benefits of the procedure, these people are often termed “competent adults”.

In most states, children under 18 years of age will need their legal guardian to sign the medical consent form on their behalf but this may vary for emancipated minors, married minors, or depending on your country or state’s laws.

In addition to being an adult, the person consenting must be considered sufficiently competent to understand the risks as well as potential benefits of the procedure, therefore a person with a mental impairment that makes it impossible for them to understand what they are signing may not be able to sign for themselves despite being over 18 years of age. In this case, someone with power of attorney for the patient, a conservator, or a court-appointed guardian may sign on their behalf.

Why is this Template Useful for Medical Professionals?

There are lots of things to consider when ensuring your patient is well-informed. Are they proficient enough in English to understand what they are consenting to? Do they agree for healthcare students to be present?

Thankfully, our medical consent form template includes spaces for all of these considerations and more, such as if the patient has had an opportunity to ask questions, or if they consent to the disposal of tissue for diagnostic purposes. 

Having a template that sets out these things for you in an easy-to-read way is an invaluable resource for practitioners, saving them time and ensuring they have covered all the relevant points when obtaining informed consent.

Benefits of Using the Medical Consent Form

Using this medical consent form template for your patients offers many benefits to your practice, including:

Keep comprehensive clinical records

As the saying goes in healthcare, if it isn’t written down- it didn’t happen! It’s a legal requirement for you to obtain written, informed consent from your patient (or their legal guardian or representative) prior to conducting a proposed treatment or procedure. Use this medical consent form to ensure your patient has understood what you discussed and is happy they have enough information to give informed consent.

Don’t leave anything out

There are lots of different aspects to giving informed consent, and while your discussion should offer your patient an opportunity to ask any questions they have- it is still important that they can read over a summary of everything they are consenting to. 

Use one form for different procedures

We have kept this form broad yet customizable so it can be used for a variety of simple medical and surgical procedures. While more complex procedures may require more extensive information than can be included in this form, using this medical consent form for the simple procedures conducted at your procedure will save you time making multiple different consent forms.

Can be used for obtaining consent for procedures on minors

This form can be completed by either a competent adult or the legal guardian or representative of a child under 18 years of age. Keep your documentation simple by using the same form template for adult and minor patients.

Space for interpreter signature

It is important to document how you ensured your patient understood what they were signing. If English is not your patient’s first language, we have included an “Interpreter was required” checkbox, and a space for the interpreter to sign the form as well. This allows you to keep track of who translated the information to the patient, and ensure all the important details are captured in your consent form.

Why Use Carepatron for Medical Practitioners?

Once your patient has completed the medical consent form, your job isn’t done yet! This form needs to be securely stored somewhere it can be accessed by other members of your patient’s care team. Using an electronic health record system like Carepatron ensures your important patient documents, such as their medical consent forms, are securely stored in a HIPAA-compliant way.

As well as this medical consent form template, Carepatron has a vast community library of other useful clinical templates ready for you to start using in your medical practice. 

On top of secure patient record storage, Carepatron offers so much more for medical practitioners. Dictate your notes directly into Carepatron using our smart speech-to-text software, manage your patients’ appointment scheduling from your Carepatron calendar and even schedule and conduct telehealth sessions right from Carepatron.

Carepatron truly offers a seamlessly integrated practice management experience, and everything within the Carepatron software has been designed to be intuitive to use and to save you time.