Agreement To TreatmentConsent Form • February 2nd, 2021
Contract Type FiledFebruary 2nd, 2021This section is completed with you by the anaesthetist usually on the day of surgery Proposed anaesthesia: General � Local � Regional � Spinal/epidural � Sedation � (Please tick)Other: Risk discussionSore throat � Nausea/vomiting � Dental damage � Allergic reaction � Itch � Blood clots �Block failure � Nerve damage � Headache � Hypotension � Rare serious events � Pain � Bleeding � All of the above discussed � Pain relief planOral � Intravenous � PCA � Epidural � Spinal � Wound catheter � PR � Other �Discussion notes: