INFORMED CONSENT FOR INVASIVE, …
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION INFORMED CONSENT FOR invasive , DIAGNOSTIC, medical & surgical procedures Chart No. Name Ward No. (Patient Imprint Card) FORM B-1 I hereby permit (Name of Attending Physician or Authorized Health Care Provider) or his/her Associate Attending Physician of the same service, and assistants as may be selected and supervised by him/her to perform the following medical treatment, operation, or procedure (hereafter called the procedure ): The procedure has been explained to me and I have been told the reasons why I need the procedure. The risks of the procedure have also been explained to me. In addition, I have been told that the procedure may not have the result that I expect. I have also been told about other possible treatments for my condition and what might happen if no treatment is received.
new york city health and hospitals corporation informed consent for invasive, diagnostic, medical & surgical procedures chart no. name ward no.
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