Patient Consent Templates

This form is used for authorizing the release of information in the state of Vermont. It allows individuals to give consent for their personal information to be shared with specific parties.

This form is used for obtaining consent from a patient in Alabama before performing a hysterectomy, which is the surgical removal of the uterus.

This Form is used for obtaining consent for family planning services in Alabama.

This document is used for obtaining disclosure and consent from patients in Texas before receiving medical care or surgical procedures.

This document is used for disclosing information and obtaining consent for radiation therapy in the state of Texas.

This Form is used for attesting to the security measures implemented for clinical management of behavioral health services in Texas.

This form is used for authorizing the use or disclosure of protected health information in the state of Texas.

This Form is used for patients to attest their connection with oral health services in Washington.

This document is a patient attestation form for oral health connections in Washington, specifically for individuals who speak Chinese Simplified. It is used to provide proof and agreement regarding oral health services.

This type of template is used to permit a clinical expert to carry out an HIV immune response test on an individual.

This Form is used for authorizing the release of medical information in Austin, Texas. It is available in both English and Spanish.

This Form is used for authorizing the disclosure of protected health information at New Hampshire Hospital in New Hampshire.

This form is used for obtaining informed consent from a patient undergoing a hysterectomy procedure in the state of Oregon.

This form is used for authorizing the release of your medical information in the state of South Dakota.

This document is used for obtaining physician authorization in the state of Vermont. It is required for certain medical procedures or treatments.

This form is used for the limited release of health information in accordance with HIPAA regulations in the state of New York, specifically for individuals who speak Italian.

This document is a consent form for the Imvamune vaccine in Nunavut, Canada. It is written in Inuktitut, a language spoken by the Inuit people of the region. The form is used to obtain permission from individuals before administering the vaccine.

This form is used for authorizing the release of limited health information in compliance with HIPAA regulations in New York. It is available in both English and Urdu languages.

This form is used for requesting a limited release of health information under HIPAA regulations in New York. It is available in both English and French languages.

This document is used for obtaining patient consent for evidence collection and release or storage in cases of sexual assault in New York. It is available in Haitian Creole.

This Form is used for obtaining patient consent for collecting and storing evidence in cases of drug-facilitated sexual assault in New York.