PATIENT CONSENT FOR PROCEDURE MINOR SURGERY/EXCISION OR SKIN BIOPSY

PATIENT CONSENT FOR PROCEDURE
MINOR SURGERY/EXCISION OR SKIN BIOPSY

Procedure:

I understand the nature of the procedure that has been recommended.

I have been informed of the benefits to be expected from this procedure as it compares to other available alternatives.

Possible Complications:

I hereby give my voluntary consent to the procedure described above.

I give my permission for a message to be left for me explaining the result of the biopsy or biopsies (initials),

Telephone Number:

Date:

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature