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Referral Surgical Services Consent Form Patient: Owner: Veterinary Clinic/Hospital: Referring Veterinarian: Surgical Procedure: TPL Surgery Date of Surgery: Your pet will have their knee stabilized
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How to fill out referral surgical services consent
How to fill out referral surgical services consent
01
Begin by reviewing the referral surgical services consent form.
02
Fill in the patient's personal information, including their name, date of birth, and contact details.
03
Provide the name of the referring physician or healthcare provider.
04
Specify the reason for referral and the surgical procedure that is being recommended.
05
Discuss any risks or potential complications associated with the surgery and make sure the patient understands them.
06
Get the patient's signature on the consent form, indicating their agreement and understanding of the referral surgical services.
07
Document the date and time the consent form was signed.
08
Keep a copy of the completed referral surgical services consent form for your records.
Who needs referral surgical services consent?
01
Anyone who requires surgical services and has been referred by a physician or healthcare provider needs a referral surgical services consent form.
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