Common Contracts
2 similar Shared Care Agreement contracts
Royal Wolverhampton NHS Trust Wolverhampton Shared Care Agreement Wolverhampton Clinical Commissioning GroupShared Care Agreement • April 24th, 2023
Patient Consent I confirm the risks and benefits of treatment, the baseline tests conducted, the need for monitoring, how monitoring will be arranged, and the roles of the consultant and GP, and my role in shared care have been explained to me. I confirm I have been provided with a copy of this shared care information. I will tell the specialist or GP if I do not have a clear understanding of the treatment. I will share any concerns in relation to the above treatment. I will report any adverse effects to the specialist or GP whilst taking the above treatment. Additionally if prescribing is unlicensed I am aware that azathioprine is not licensed to treat my condition but the risks and benefits have been explained to me and I agree to take this medicine as prescribed.
Royal Wolverhampton NHS Trust Wolverhampton Shared Care Agreement Wolverhampton Clinical Commissioning GroupShared Care Agreement • October 8th, 2018
Patient Consent I confirm the risks and benefits of treatment, the baseline tests conducted, the need for monitoring, how monitoring will be arranged, and the roles of the consultant and GP, and my role in shared care have been explained to me. I confirm I have been provided with a copy of this shared care information. I will tell the specialist or GP if I do not have a clear understanding of the treatment. I will share any concerns in relation to the above treatment. I will report any adverse effects to the specialist or GP whilst taking the above treatment. Additionally if prescribing is unlicensed I am aware that azathioprine is not licensed to treat my condition but the risks and benefits have been explained to me and I agree to take this medicine as prescribed.
