��������Ƶ

1. Interpreter Declaration: Required when the patient's primary language is not the language used in the consent form

2. Legal Representative Authorization: Required when consent is given by someone other than the patient (e.g., parent, guardian, or power of attorney)

3. Clinical Photography Consent: Required when the procedure may involve medical photography or recording

4. Blood Product Administration: Required when treatment might involve blood transfusion or blood products

5. Research Participation: Required when the treatment is part of a clinical study or research program

6. Religious or Cultural Considerations: Required when specific religious or cultural preferences need to be documented

1. Appendix A - Procedure Details: Detailed technical description of the medical procedure or treatment

2. Appendix B - Risk Disclosure: Comprehensive list of potential risks and complications

3. Appendix C - Post-Treatment Care: Instructions for post-procedure care and recovery

4. Appendix D - Emergency Contacts: List of emergency contact numbers and procedures

5. Appendix E - Cost Estimate: Estimated costs of treatment and related services (if applicable)