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consent_form [2015/11/03 11:47]
wikiadmin created 		consent_form [2016/01/19 06:36] (current)
peter_sy
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 +#Consent
 ###Features ###Features
   * simplicity; less legalese; easily translatable to local language   * simplicity; less legalese; easily translatable to local language
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   * Admitting Order: To be accomplished by Attending Physician   * Admitting Order: To be accomplished by Attending Physician
 \\ \\
 +
 +----
 +#Hospital Facility, In-Patient
 ###Draft for Patient Admission Form ###Draft for Patient Admission Form
 Agreement and Consent Agreement and Consent
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 +###Draft for Admitting Order
  
 +Agreement ​
  
 +      I have explained to <name of patient/​family/​guardian to be filled out by hand writing> the Agreement under Patient Admission Form, the nature of the patient’s condition as well as the necessity of the hospital admission. I have discussed the need for him to consent separately to medical procedures that may be required later.
  
 +       All questions were answered and the patient/​family/​guardian consents to the hospital admission and the collection and processing of the patient health information by this hospital, its health professionals,​ the Philippine Health Information Exchange (PHIE) and for public health purposes sanctioned by a duly constituted,​ independent Health Information Use and Safety Monitoring Board. I also explained that suitable safeguards (including, but not limited to, anonymization of personal identifiers) have been put in place, so as to protect the privacy, welfare and other fundamental rights of the patient.
  
 +
 +       ​Attending Physician / Date
 +
 +
 +
 +----
 +
 +#Hospital Facility, Out-Patient
 +
 +
 +----
 +###See Also
 +  * [[consent_rules|Consent Rules]]
 +  * [[consolidated_workshop_outputs|Consolidated Workshop Outputs]]
 +\\
  
  
 +----