The Consent For Surgery Form is a mandatory document required by Hong Kong healthcare regulations before performing any surgical procedure. This document serves as evidence of informed consent and protects both healthcare providers and patients by clearly documenting the agreement to proceed with surgery. It includes detailed information about the proposed procedure, risks, benefits, and alternatives, ensuring compliance with Hong Kong's Medical Registration Ordinance and related healthcare regulations. The form is designed to be used in both public and private healthcare settings, accommodating various scenarios such as emergency procedures, procedures requiring guardian consent, and cases requiring language interpretation. It represents a crucial component of medical documentation and risk management in surgical practice.
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1. Patient Information: Patient's full name, ID number, date of birth, contact details, and medical record number
2. Healthcare Provider Information: Name of hospital/clinic, treating physician, and department
3. Procedure Details: Detailed description of the proposed surgical procedure in both medical and lay terms
4. Risks and Benefits: Clear explanation of potential risks, complications, and expected benefits of the procedure
5. Alternative Treatments: Description of alternative treatment options and consequences of not proceeding
6. Anesthesia Consent: Information about anesthesia type, risks, and specific consent for anesthetic procedures
7. Patient Declaration: Patient's confirmation of understanding and voluntary consent to proceed
8. Signatures: Designated spaces for patient/guardian signature, physician signature, and witness signature with dates
1. Interpreter Declaration: Section for interpreter details and confirmation when patient requires language assistance
2. Guardian Consent: Additional section when patient is a minor or lacks capacity to consent
3. Photography Consent: Optional consent for surgical photography or recording for medical documentation
4. Blood Product Refusal: Specific section for patients refusing blood products for religious or personal reasons
5. Emergency Modification: Consent for modification of surgical plan if unexpected findings during surgery
1. Procedure Information Sheet: Detailed medical information about the specific procedure including diagrams and preparation instructions
2. Post-Operative Care Instructions: Detailed instructions for post-surgical care and recovery
3. Anesthesia Information Sheet: Detailed information about anesthesia types, risks, and preparation requirements
4. Hospital-Specific Policies: Relevant hospital policies affecting the surgical procedure and patient care
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