Get the free IHS-966 Informed Consent for Use of Protective Stabilization 01

IHS966 (01/2014) DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Informed Consent for use of Protective Stabilization includes: the use of a Papoose Board, Velcro straps, or being restrained

How to fill out ihs-966 informed consent for

How to fill out the IHS-966 informed consent form:

1. Begin by carefully reading the instructions and the form itself. Familiarize yourself with the purpose of the form and the information it requires.
2. Provide the required personal information, such as your name, address, date of birth, and contact details. Ensure that the information you provide is accurate and up-to-date.
3. Identify the healthcare provider or organization that will be providing the services. This may include their name, address, and contact information.
4. Review the description of the procedure or treatment being offered. Make sure you understand the potential risks, benefits, and alternatives associated with the procedure, as this information will help you make an informed decision.
5. Consider any potential complications or side effects that may arise from the procedure or treatment. Be aware of the possible risks involved and discuss them with your healthcare provider if needed.
6. You may be asked to provide information about any allergies or medical conditions that could impact the procedure or treatment. Be honest and thorough in your responses, as this will assist in tailoring your healthcare to your specific needs.
7. If necessary, indicate any additional consents that are required for specific procedures or treatments. This may include additional signatures or checkboxes to indicate your agreement to specific conditions or aspects of the healthcare.
8. Once you have completed the form, review it carefully to ensure that you have provided all the necessary information and that it is accurate. If you have any questions or concerns, don't hesitate to ask your healthcare provider for clarification.

Who needs the IHS-966 informed consent form:

1. Individuals who are receiving medical, surgical, or other healthcare procedures or treatments may need to fill out the IHS-966 informed consent form. This includes both adults and minors, depending on the specific circumstances and legal requirements.
2. The form is typically required for procedures that involve a certain level of risk or have potential complications. It ensures that patients are fully informed about the treatment or procedure and have given their consent to proceed.
3. The IHS-966 informed consent form may be needed in various healthcare settings, such as hospitals, clinics, outpatient centers, and specialized medical facilities. It serves as a legal document to protect both the patient and the healthcare provider by documenting the consent for the procedure or treatment.

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