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MK347501003 Main ICD BE LEN V2.0 29Aug2013 PATIENT INFORMATION and CONSENT DOCUMENT Study Name: A Phase II×III Randomized Trial of Two Doses of MK3475 (SCH900475) versus Docetaxel in Previously Treated

How to fill out patient information and consent

How to fill out patient information and consent:

1. Start by gathering all the necessary forms from the healthcare provider. These forms typically include a patient information sheet and a consent form.
2. Begin by carefully reading the instructions provided on each form. Ensure that you understand the purpose of providing the requested information and giving consent.
3. The patient information sheet will typically ask for basic details such as your name, date of birth, address, contact information, and insurance information. Fill in these details accurately and legibly.
4. In addition to personal information, you may be required to provide your medical history, including any existing conditions, allergies, medications you are currently taking, and previous surgeries or treatments. Be thorough and provide accurate information to ensure proper care.
5. Consent forms require you to give permission for specific medical procedures, treatments, or sharing of personal information. Read the form thoroughly and understand what you are consenting to. If you have any questions or concerns, do not hesitate to ask the healthcare provider for clarification.
6. When signing the consent form, use your legal signature. Make sure it is clear and matches your identification for verification purposes.
7. Once you have completed filling out all the forms, review them to ensure accuracy and completeness. Correct any errors or missing information.
8. Return the completed forms to the healthcare provider as instructed. Keep copies for your own records, if necessary.

Who needs patient information and consent?

1. Healthcare providers require patient information and consent to ensure accurate and personalized care. The information provided helps them understand the patient's medical history, current health status, and any specific needs or concerns.
2. Consent is necessary to protect patients' rights and ensure they have control over their medical decisions. It provides legal authorization for healthcare providers to perform specific procedures, treatments, or share medical information as outlined in the consent forms.
3. Patients also benefit from providing accurate information and giving consent. It enables healthcare providers to tailor their care, minimize risks, and deliver the most appropriate and effective treatments. Consent ensures the patient's active involvement in their own healthcare journey.

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