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CONSENT FOR ADMISSION / TREATMENT
mychart.utsouthwestern.eduFORM # 80935 (06/07) (Rev. 07/08/2020) White - Health Information Management Yellow - Patient Location of treatment: cUT Southwestern University Hospital Outpatient c Surgery Center (clinic name) 1. APPLICATION FOR ADMISSION AND CONSENT FOR TREATMENT: I voluntarily consent to the procedures and services that may be performed for me on an …
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www.utsouthwestern.eduthe button on the Project Setup page. All survey and data entry features/functions will be exactly the same as they are in development with the exception of certain Project Setup features.