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Narrow Band UVB Phototherapy Consent Form I confirm that: 1. Have you ever had any of the below please circle Sun Spots (10 or more) Yes / No Basal Cell Carcinoma Yes / No Squamous Cell Carcinoma
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How to fill out phototherapy consent form
How to fill out phototherapy consent form
01
Step 1: Make sure the patient or legal guardian understands the purpose and risks of phototherapy.
02
Step 2: Provide the consent form and explain all sections to the patient or legal guardian.
03
Step 3: Answer any questions or concerns the patient or legal guardian may have.
04
Step 4: Have the patient or legal guardian sign and date the consent form.
05
Step 5: Keep a copy of the signed consent form in the patient's medical records.
Who needs phototherapy consent form?
01
Patients who are undergoing phototherapy treatment.
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What is phototherapy consent form?
The phototherapy consent form is a document that provides permission for a patient to undergo phototherapy treatment, which involves exposing the skin to ultraviolet light to treat certain skin conditions.
Who is required to file phototherapy consent form?
The patient or their legal guardian is required to file the phototherapy consent form.
How to fill out phototherapy consent form?
To fill out the phototherapy consent form, the patient or their legal guardian needs to provide their personal information, signature, and date.
What is the purpose of phototherapy consent form?
The purpose of the phototherapy consent form is to ensure that the patient understands the risks and benefits of phototherapy treatment and consents to undergo the procedure.
What information must be reported on phototherapy consent form?
The phototherapy consent form must include the patient's personal information, medical history, any allergies, current medications, and a statement of consent.
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