Consent Form

Specialty: Emergency Medicine Specialist **Consent** Procedure: **Laceration Repair - Forehead** This consent form outlines the agreement for the patient, Mr. John Smith, to undergo a laceration repair procedure on his forehead. The purpose is to close the wound, prevent infection, and promote optimal healing and cosmetic outcome. Risk: * Bleeding * Infection * Scarring (including hypertrophic or keloid) * Nerve damage (rare, leading to numbness or weakness) * Allergic reaction to local anaesthetic or sutures * Pain or discomfort * Failure of wound to heal properly Alternatives: * Steri-Strips or tissue adhesive (for very superficial wounds) * No treatment (risk of infection, poor cosmetic outcome, prolonged healing) * Referral to plastic surgery (for complex lacerations, though immediate repair is often necessary in ED) * Option to decline the procedure entirely All questions answered Agreeable with plan Consent form signed Patient, Mr. John Smith, verbally confirmed understanding of the procedure, risks, benefits, and alternatives, and provided explicit consent for the laceration repair. Consent form signed by patient and witnessed.