Assess on Admission It is usual practice for us to see patients in the clinic, perform an examination to assess you, review imaging and discuss your injury with the you. We also discuss the management options and implications of the various treatment options. As part of the recommended consent process, we discuss the benefits, risks, complications, recovery process and return to sport times. We will also give you the relevant patient information leaflets and links. The clinical examination is an extremely important part of the assessment and decision-making process and must be done before any treatment is undertaken. I note that you have chosen to be seen and clinically examined on the same day as the proposed surgery, due to geographical, time-scheduling and travel reasons. We have agreed to do this for you, based on the prior information from your clinician. However, there is a chance that we may not be able to proceed to the planned surgery should anything be different or changed. In order to proceed with this, please can you sign the declaration statement below: Patient Declaration: I have chosen to have my clinical examination on the same day as the pre-planned surgery. As such, I understand the implications of not attending beforehand and that all the procedures and alternatives may not have been fully explained to me in advance. I understand that there is a chance that we may not be able to proceed with the surgery on the same day. Signature(Required)Name(Required)Date(Required) DD slash MM slash YYYY Δ