Patient Agreement to Treatment Sample Contracts

Agreement to treatment Peninsula Dental Social Enterprise (A3)

Patient Agreement to Treatment • May 14th, 2019

• Contract Type
  Patient Agreement to Treatment
• Filed
  May 14th, 2019

PATIENT AGREEMENT TO TREATMENT INSERTION AND REMOVAL OF RUTHENIUM PLAQUE

Patient Agreement to Treatment • July 14th, 2022

• Contract Type
  Patient Agreement to Treatment
• Filed
  July 14th, 2022

Risks include local tumour recurrence, radiation maculopathy and optic neuropathy (which is damage to the central part of the retina and the optic nerve caused by radiation). This may result in loss of peripheral and central vision. If manipulation of muscles is involved, you may experience double vision following the procedure. The risk of metastasis to the liver after this treatment is about the same as after removal of the eye. This risk has been discussed with you during your consultation and is based

Patient agreement to Treatment

Patient Agreement to Treatment • July 26th, 2018

• Contract Type
  Patient Agreement to Treatment
• Filed
  July 26th, 2018

 There is a small chance of getting an infection during the first 20 days after the IUCD is inserted. Your risk of infection can be increased if you have changed partner in the last 6 – 12 months. If you have experienced any irregular bleeding, bleeding after intercourse or any unusual vaginal discharge please let the clinician undertaking your procedure know.