Consent Forms In The Clinic

Five Things To Do

Ask Questions – If you don’t understand something, ask them to clarify or provide you with additional information. A word or term may have a complex definition. For example, the definitions of Treatment, Payment, and Health Care Operations are hundreds of words long.

Refuse to Sign – Don’t sign anything if you are uncomfortable with it.

Limit Data Sharing – If you are paying out of pocket IN FULL (no insurance or government program assistance), you can request the data from that visit not be shared with your insurance company.

Request Different Form – Since some health care facilities have forms that say you cannot make changes, request a consent form limited to treatment and payment.

Get a Copy – Always ask for a copy of your consent form with your signature to keep for your records.

Sample Forms  Suggested Changes

Note: These forms are different than the consent forms found on the “At the Hospital” webpage.

Over the years, we have collected consent forms from patients or found them online. The following include examples of a good consent form as well as forms that contain things to watch out for and our suggested changes. You may prefer fewer or more changes. You are free to follow our suggestions at your own discretion.

You can send your consent forms to us. 

Unaltered forms are preferred, however, if the form is completed we will redact all personal information.

Example of a Good Consent Form:

Language to Watch Out for in Consent Forms:

Note – Although some items are highlighted, other items may be of concern to you, so read carefully!

Suggested Changes to Consent Forms:

September 13, 2023

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