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Declaration of consent / patient form Version 03/2023 ___rztezentrum Sdbahnhof AG I Sdbahnhofstrasse 12 1 3007 / Bern I www.suedbahnhof.ch I suedbahnhof@hin.ch I Sate 2 on 3Patient form Personal details
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Read through the consent declaration or form carefully to understand the information being requested.
02
Fill in your personal details accurately, such as your full name, date of birth, and contact information.
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Sign and date the consent declaration or form to indicate your agreement to the terms and conditions.
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Ensure that all required fields are completed before submitting the form.
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Make a copy of the completed form for your records before submitting it to the relevant party.

Who needs consent declarations and forms?

01
Anyone who is required to provide consent for a particular activity, such as medical treatment, research participation, or data sharing.
02
Organizations that collect personal information and need to obtain permission from individuals to use that information for specific purposes.
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Consent declarations and forms are legal documents that individuals or entities use to provide their permission or agreement for a specific action or process, often in the context of data sharing or regulatory compliance.
Typically, individuals or organizations that need to share sensitive information or require consent for a legal process are required to file consent declarations and forms.
To fill out consent declarations and forms, one must provide personal or organizational information, specify the action for which consent is being granted, and sign the document to affirm agreement.
The purpose of consent declarations and forms is to ensure that all parties involved have mutual understanding and agreement regarding the sharing or use of information, thereby protecting legal rights.
Information that must be reported includes the identities of the parties involved, the purpose of consent, details about the data or actions consented to, and signatures of those providing consent.
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