Surgical Consent Form - Consultant

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Statement of health professional

To be completed by health professional with appropriate knowledge of proposed procedure

I have also discussed what the procedure is likely to involve, the possibility of any extra procedures which may become necessary during the procedure, the benefits of any available alternative treatments (including no treatment) and any particular concerns of this patient/parent.

The following information has been provided:
The procedure will involve:
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Statement of patient

Once filled in please submit. It will be sent to the patient to complete. You will be informed upon completion.