Miscellaneous Informed Consent Samples

Authorization for Use or Disclosure of Health Information

Authorization to Disclose Protected Health Information Specifically Photographs/Films/Videos

Blood Transfusion

Chiropractic Care

Confidentiality Statement

Elements of an Informed Consent (Procedure Common and Technical Names)

Off-Label Use of (Name of Device)

Off-Label Use of (Name of Prescription Drugs)

Refusal to Consent to Treatment, Medication, or Testing

Temporary Authorization (Minor)

Sample Forms