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1. Interpreter Declaration: Required when the patient's primary language is not English or Filipino, including interpreter's certification of accurate translation

2. Guardian Authorization: Required for minors or patients who lack capacity to provide informed consent

3. Photography Consent: Optional permission for medical photography or recording for documentation or educational purposes

4. Blood Product Authorization: Required for procedures that may need blood transfusions, with option to refuse

5. Research Participation: Optional consent for use of medical information in research studies

6. Religious or Cultural Preferences: Optional section for documenting specific religious or cultural requirements during treatment

1. Appendix A - Procedure Details: Detailed medical diagrams or additional information about the specific procedure

2. Appendix B - Post-Procedure Care: Instructions for post-procedure care and recovery

3. Appendix C - Emergency Contacts: List of emergency contacts and their relationship to the patient

4. Appendix D - Medication List: Current medications, allergies, and relevant medical history

5. Schedule 1 - Fee Schedule: Detailed breakdown of procedure costs and payment terms if applicable