The Medical Release of Liability Waiver is an essential document in Indonesian healthcare practice, designed to protect healthcare providers while ensuring patient awareness and consent. This document is typically used before conducting medical procedures, treatments, or services where there are inherent risks involved. It must comply with Indonesian healthcare regulations, particularly Law No. 36 of 2009 on Health and Minister of Health Regulation No. 290/MENKES/PER/III/2008 regarding informed consent. The waiver includes comprehensive information about medical procedures, potential risks, and liability limitations, while preserving mandatory patient rights under Indonesian law. Healthcare providers should implement this document as part of their risk management strategy, ensuring it's properly executed and witnessed before conducting medical procedures.
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1. Parties: Identification of the healthcare provider/facility and the patient (including full legal names, addresses, and identification numbers)
2. Background: Context of the medical treatment or procedure and the purpose of the waiver
3. Definitions: Clear definitions of key terms used in the waiver, including 'medical services', 'liability', 'negligence', and specific medical procedures
4. Acknowledgment of Risks: Detailed description of potential risks and complications associated with the medical treatment or procedure
5. Voluntary Participation: Statement confirming that the patient is voluntarily participating in the medical treatment and signing the waiver
6. Release of Liability: Specific terms of the liability release, including scope and limitations under Indonesian law
7. Medical Consent: Express consent for the specified medical procedures and treatments
8. Emergency Authorization: Authorization for emergency medical treatment if necessary
9. Governing Law: Statement that the waiver is governed by Indonesian law and jurisdiction
10. Execution: Signature blocks, witness requirements, and date of execution
1. Insurance Declaration: Section addressing the patient's insurance coverage and responsibility for costs - include when insurance matters are relevant
2. Medical History: Section for relevant medical history disclosure - include for more complex procedures or when medical history is crucial
3. Photography Consent: Authorization for medical photography - include when procedures may require documentation
4. Translation Declaration: Statement that the document has been explained in the patient's preferred language - include when the patient is not fluent in the document's language
5. Religious or Cultural Considerations: Specific provisions related to religious or cultural requirements - include when relevant to the patient's beliefs
1. Schedule A - Specific Procedures: Detailed description of the medical procedures covered by the waiver
2. Schedule B - Risk Disclosure: Comprehensive list of specific risks and potential complications
3. Schedule C - Pre-existing Conditions: List of relevant pre-existing medical conditions if applicable
4. Appendix 1 - Patient Rights: Summary of patient rights under Indonesian law that remain in effect
5. Appendix 2 - Emergency Contacts: List of emergency contacts and their contact information
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Healthcare
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Hospitals
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Alternative Medicine
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Diagnostic Services
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Mental Health Services
Sports Medicine
Relevant Teams
Legal
Compliance
Risk Management
Patient Relations
Medical Administration
Quality Assurance
Clinical Operations
Medical Records
Front Desk Administration
Healthcare Operations
Relevant Roles
Medical Director
Hospital Administrator
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Risk Management Officer
Compliance Officer
Medical Practitioner
Nurse Manager
Clinical Director
Patient Relations Manager
Quality Assurance Manager
Healthcare Facility Manager
Medical Records Officer
Administrative Coordinator
Practice Manager
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