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CLINICAL ETHICS COMMITTEE 2015 CONSULTATION REFERRAL FORM For NEW or INNOVATIVE treatment for a specific patient or patient group Please note: the CEC is required to review proposals for new and innovative
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How to fill out ethics consultation referral form

01
Read the instructions provided with the ethics consultation referral form.
02
Gather all the necessary information required to fill out the form, such as the patient's details, the reason for the referral, and any relevant medical records.
03
Start by entering the patient's demographic information accurately, including their name, age, gender, and contact details.
04
Next, provide a detailed description of the reason for the ethics consultation referral. Clearly explain the ethical dilemma or issue that requires attention.
05
If applicable, attach any supporting documents or medical records that may help the ethics committee make an informed decision.
06
Review the filled-out form to ensure all the provided information is accurate and complete.
07
Submit the ethics consultation referral form to the designated authority or ethics committee as per the instructions provided.
08
Keep a copy of the form for your records.
09
If any additional information or updates are required, promptly provide them to the ethics committee.

Who needs ethics consultation referral form?

01
Medical professionals seeking guidance on ethical dilemmas or issues in patient care.
02
Patients or their legal representatives who believe an ethical concern needs to be addressed.
03
Healthcare institutions or organizations implementing a standardized process for addressing ethics-related matters.
04
Researchers conducting studies involving human subjects and require ethical approval.
05
Anyone involved in healthcare decision-making or policy development that necessitates ethical considerations.
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The ethics consultation referral form is a document used to request advice or guidance on ethical issues from a designated ethics committee or consultant.
Anyone facing ethical dilemmas or questions related to their work or personal life may file an ethics consultation referral form.
The ethics consultation referral form typically requires basic information about the individual seeking consultation, a description of the ethical issue, and any relevant background information.
The purpose of the ethics consultation referral form is to provide a structured process for seeking guidance on ethical matters and to ensure that ethical standards are upheld.
The information to be reported on the ethics consultation referral form may include the nature of the ethical issue, the individuals involved, relevant policies or guidelines, and any potential conflicts of interest.
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