Consent Forms

Standard consent forms and forms for adults who are unable to consent for themselves are available for download.

Consent Form 1 – Patient agreement to investigation, treatment or procedure

Consent Form 2 – Parental agreement to investigation, treatment or procedure for a child or young person

Consent Form 3 – Patient Parental agreement to investigation, treatment or procedure where consciousness not impaired

Clinical Photography/Video Consent Form

 

Combined consent/capacity form for community staff on first visit/admission to case load.

This form was launched in August 2014 for staff working in the community to establish the patient’s ability to provide consent on admission to caseload and prompts a mental capacity assessment if required. This form should be ordered from web basket – code ND0023.

Mental Capacity Assessment and Best Interest Decision form

This is the Form for those patients aged 16 years or over who are unable to consent to investigation or treatment. This form should only be used where the patient has an impairment or disturbance in the functioning or their mind or brain (e.g. a dementia, learning disability, brain injury etc) that is thought to impact their ability to give informed consent i.e. lacks capacity to give or withhold consent to treatment. Detailed guidance and completed example are contained within the Mental Capacity Act policy

About the Consent Form – Advice for Patients

This is guidance and advice for patients who are being asked to fill in a Consent form.

The use of Form 3 is optional but may be thought more appropriate than Form 1 in situations where patients do not need to be made aware of issues surrounding a general or regional anaesthesia and do not need to make advance decisions about additional procedures because they will be in a position to make any such decision at the time if necessary.

 

Last updated: September 1, 2014