Common Contracts
1 similar Covid-19 Informed Consent Agreement contracts
COVID-19 INFORMED CONSENT AGREEMENTCovid-19 Informed Consent Agreement • May 3rd, 2020
I, the undersigned patient, consent to have Dr. Binstock, Dr. Layton or S. Cullinane PA-C, and/or his/her staff (hereinafter collectively “my Doctor”) perform medical procedures, whether regarded as necessary, elective or aesthetic, during the time of the COVID-19 pandemic and after. I understand having my procedure performed at this time, despite my own efforts and those of my Doctor, may increase the risk of my exposure to COVID-19. I am aware that exposure to COVID-19 can result in severe illness, intensive therapies, extended intubation and/or ventilator support, life-altering changes to my health, and even death. I am also aware of the possibility that the procedure itself, may result in a more severe case of COVID-19 than I might have had without the procedure, in the event I currently have or should in the future acquire the COVID-19 infection.
