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1. Special Medical Conditions: Section for disclosure of pre-existing conditions or allergies - used when relevant to the treatment

2. Insurance Details: Information about medical insurance coverage - included when insurance coordination is relevant

3. Photo/Video Release: Authorization for taking and using medical photographs or videos - used in cosmetic procedures or for documentation purposes

4. Witness Requirements: Space for witness signatures - included when required by provincial law or facility policy

5. Translation Declaration: Statement regarding translation of the document - used when the patient's primary language is not English

6. Capacity Assessment: Confirmation of patient's mental capacity - included for high-risk procedures or elderly patients

7. Survival of Obligations: Provisions that survive termination of the agreement - included for long-term or complex treatments

1. Schedule A - Specific Procedures: Detailed description of medical procedures or treatments covered by the release

2. Schedule B - Risk Disclosure: Comprehensive list of specific risks and potential complications

3. Schedule C - Pre/Post Treatment Instructions: Detailed instructions for before and after the medical procedure

4. Appendix 1 - Medical History Form: Standard form for patient's medical history and current conditions

5. Appendix 2 - Emergency Contact Information: Details of emergency contacts and authorized decision-makers

6. Appendix 3 - Facility Policies: Relevant facility policies and procedures that affect patient care