Informed Consent Documentation

(Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or section blank.) Proposed treatment: [details of the health care to be provided, including indication] Risks and benefits: [detailed notes on the benefits and risks discussed] Response: [patient’s response including specific concerns raised] [Questions raised by the patient and the responses provided] Alternative options: [Details of other options considered, including risks of not treating] Resources provided [education resources provided including type of media, title, URL, publisher, version number if mentioned in context or transcript] Consent process: [specify if consent was obtained verbally or in written form with signature] [date and time consent was attained] [Full name, title and signature of the doctor obtaining consent] [Full names of the doctors providing the health care] (if different to the doctor obtaining consent) Additional: (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank) [if the person refuses care, withdraws consent or revokes a previous refusal/withdrawal] [where the patient states they do not want further information] [process used to determine the person’s competency to consent e.g. Gillick Competence, Socratic questioning] [how communication barriers were addressed or a substitute decision-maker used if required]