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1. Patient Information: Details of the minor patient including full name, date of birth, NHI number, and address
2. Parent/Guardian Information: Details of the parent(s) or legal guardian(s) providing consent, including their relationship to the patient
3. Healthcare Provider Information: Details of the healthcare provider/facility, including registration numbers and contact information
4. Nature of Treatment/Procedure: Clear description of the medical treatment, procedure, or care to be provided
5. Risks and Benefits: Detailed explanation of potential risks, benefits, and alternatives to the proposed treatment
6. Emergency Contact Information: Secondary contacts in case parent/guardian cannot be reached
7. Consent Declaration: Formal statement of consent including acknowledgment of information received and understanding
8. Duration of Consent: Timeframe for which the consent remains valid
9. Privacy Statement: Information about how the patient's medical information will be used and protected
10. Signatures: Space for dated signatures of parent/guardian, witness, and healthcare provider
1. Interpreter Declaration: Required when consent discussions are conducted through an interpreter
2. Photography/Recording Consent: Required when the procedure may involve medical photography or recording
3. Blood Products Consent: Required when treatment might involve blood transfusions or blood products
4. Research Participation: Required when the treatment is part of a research study
5. Teaching Institution Statement: Required when the facility is a teaching institution where students may be involved in care
6. Cultural Considerations: Required when specific cultural practices or preferences need to be documented
7. Telehealth Consent: Required when services may be provided via telehealth
8. Multiple Provider Authorization: Required when treatment involves multiple healthcare providers or facilities
1. Appendix A: Detailed Procedure Information: Detailed technical information about specific procedures or treatments
2. Appendix B: Post-Procedure Care Instructions: Detailed instructions for care after the procedure or during treatment
3. Appendix C: Patient Rights and Responsibilities: Full description of rights under the Code of Health and Disability Services Consumers' Rights
4. Appendix D: Privacy Policy: Detailed privacy policy and information handling procedures
5. Appendix E: Emergency Protocols: Detailed emergency procedures and contact protocols
6. Schedule 1: Fee Schedule: If applicable, breakdown of any associated costs or fees
7. Schedule 2: Medication Details: If applicable, detailed information about prescribed medications and their administration
Healthcare
Medical Services
Pediatric Care
Primary Healthcare
Hospital Services
Emergency Medicine
Specialist Medical Services
Allied Health Services
Mental Health Services
Dental Services
Legal
Clinical Governance
Patient Administration
Medical Records
Quality Assurance
Risk Management
Patient Services
Compliance
Clinical Operations
Front Desk Operations
Medical Director
Clinical Director
Pediatrician
General Practitioner
Nurse Manager
Registered Nurse
Healthcare Administrator
Medical Records Manager
Legal Compliance Officer
Risk Management Officer
Patient Services Manager
Clinical Governance Manager
Practice Manager
Quality Assurance Coordinator
Patient Rights Advocate
Medical Secretary
Admissions Coordinator
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