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USE YOUR DEPARTMENT LETTERHEAD (SURROGATE) CONSENT TOT AKE PART IN A RESEARCH STUDYThis template HRP502f should be used when obtaining consent from surrogate on behalf of an adult with impaired decision-making
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How to fill out surrogate consent to

01
Obtain the surrogate consent form from the appropriate authority or organization.
02
Fill out the personal information section of the form, providing your name, address, contact information, and relationship to the person on behalf of whom you are giving consent.
03
Specify the reason for giving surrogate consent and provide any necessary supporting documents or medical records.
04
Sign and date the form, acknowledging that you understand the implications of giving surrogate consent.
05
If required, have the form notarized or witnessed by a legal authority.
06
Submit the completed surrogate consent form to the relevant entity or individual responsible for decision-making on the matter.
07
Keep a copy of the filled-out form for your records.
08
Follow up with the relevant authority or organization to ensure that your surrogate consent has been properly recorded and taken into account.

Who needs surrogate consent to?

01
Surrogate consent is usually needed in situations where an individual is unable to make decisions for themselves due to age, incapacity, or legal restrictions.
02
Some examples of those who may require surrogate consent include minors, individuals with severe cognitive impairments, individuals under temporary incapacitation, or individuals who have designated a surrogate decision-maker in advance through legal means.

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Surrogate consent is a legal process where an individual is appointed to make medical decisions on behalf of another person who is unable to make decisions for themselves.
Surrogate consent forms are typically filed by family members or individuals designated as legally authorized surrogates.
Surrogate consent forms can be filled out by providing personal information and specifying the medical decisions the surrogate is authorized to make.
The purpose of surrogate consent is to ensure that medical decisions can be made on behalf of individuals who are unable to make decisions for themselves.
Information such as personal details of the surrogate, medical preferences of the individual, and any specific instructions for medical care.
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