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SMOKERS SURGICAL CONSENT FORM Patient Age I have been advised by Dr. Kelly, Herman, or Wolf and their staff that I must not smoke, be exposed to secondhand smoke, or take any nicotine substitutes

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How to fill out smokers surgical consent form

How to fill out a smokers surgical consent form:

01

Begin by carefully reading the entire form to familiarize yourself with its contents. Pay close attention to any specific instructions or guidelines provided.

02

Fill in the personal information section, including your full name, date of birth, address, and contact information. It is crucial to provide accurate and up-to-date information.

03

Next, provide details about your medical history. This may include any existing conditions, previous surgeries, allergies, medications, or any other relevant information. Be thorough and honest to ensure the surgical team has a comprehensive understanding of your health.

04

If you are a smoker, it is important to disclose this information. Fill in the appropriate section that asks about smoking habits, including the frequency and duration of smoking. Understanding your smoking habits helps the surgical team assess potential risks and make informed decisions during your procedure.

05

Take note of any questions or concerns you may have and leave ample space on the form to address them. Before signing the consent form, it's essential to clarify any uncertainties with your healthcare provider.

Who needs a smokers surgical consent form:

01

Patients who are smokers and are scheduled to undergo a surgical procedure typically require a smokers surgical consent form.

02

The form helps healthcare providers assess the potential risks associated with smoking and anesthesia, as well as the impact smoking may have on the healing process.

03

By obtaining informed consent, healthcare providers ensure that patients understand the potential complications and risks that may arise due to smoking before, during, and after surgery.

04

Ultimately, the purpose of the smokers surgical consent form is to facilitate open communication between patients and healthcare providers, enabling a shared decision-making process and ensuring the best possible surgical outcome.

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