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Valley Eyewear Center Medical Associates Jonathan Cavell, M.D. MPA Michael Gagnon, M.D. Gala Swaminathan, M.D. Gina Trentacosti, O.D. Jimmy Yip, O.D. Keen NGO, O.D. CONSENT FOR EMERGENCY TREATMENT

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How to fill out consent for non-emergency treatment

How to fill out consent for non-emergency treatment:

01

Obtain the consent form: First, you need to obtain the consent form from the healthcare provider or facility. This form is typically available at the front desk or can be requested from the medical staff.

02

Read and understand the form: Take your time to carefully read through the consent form. Understand what it entails and make sure you are aware of the treatment being proposed, its potential risks and benefits, and any alternatives available.

03

Provide personal information: Fill in your personal information accurately on the consent form. This includes your full name, contact details, date of birth, and any other relevant identification information required by the healthcare provider.

04

Understand the purpose: The consent form should clearly state the purpose of the treatment. Make sure you understand why the treatment is necessary and what it aims to achieve. If you have any doubts or questions, don't hesitate to seek clarification from the healthcare provider.

05

Sign and date: Once you have read the form, understood its purpose, and provided your personal information, sign and date the consent form accordingly. By signing, you acknowledge that you have understood the treatment and its potential risks, and you agree to proceed with it.

Who needs consent for non-emergency treatment?

01

Patients: Patients themselves are required to provide consent for non-emergency treatment. This ensures that they have a clear understanding of the proposed treatment and are willing to proceed with it after evaluating the potential risks and benefits.

02

Legally authorized representatives: If a patient is unable to provide consent due to incapacitation or being a minor, then their legally authorized representative, such as a parent, guardian, or healthcare power of attorney, can provide consent on their behalf. This allows the representative to make healthcare decisions in the best interest of the patient.

03

Healthcare providers and facilities: Medical professionals and healthcare facilities also have a responsibility to ensure that they obtain informed consent from patients or their authorized representatives before providing non-emergency treatment. This is done to ensure transparency, respect patient autonomy, and legally protect both the provider and the patient.

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