Signature of Patient definition

Signature of Patient. Print please: Date: A witness should sign below i f t he patient is unable to sign but has indicat ed his or her consent. Young people / childr en may also like a par ent to sign her e. (S ee DOH guidelines). Signed Date_ Name (PRINT) Confirmation of consent ( to be comple t ed by a healt h prof essional when t he pa t ient is admitt ed for t he procedur e, if t he patient has signed t he form in advance). On behalf of t he t eam t r eating t he pa t ient, I have confirmed wit h t he patient t ha t s / he has no fur t her ques t ions and wishes t he procedur e to go ahead. Signature of Health Professional Job Title Printed Name Date I mportant notes: (tick if applicable) . See also advance dir ec t ive / living will (eg J ehovah’s Witness form) .
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Signature of Patient. Date: Time: Signature of Provider: Date: Time: Chart Location: Consents
Sample 1

Examples of Signature of Patient in a sentence

  • Signature of Patient or Authorized Representative below confirms Patients agreement to the terms of the Participation Agreement, Use of Medical Records, Release of Medical Records and Consent to Assume Risk.

Related to Signature of Patient

  • Signature means a tangible symbol or an electronic signature that evidences the signing of a record.

  • Diagnosis of autism spectrum disorder means medically necessary assessments, evaluations, or tests

  • Facsimile signature means a signature engraved, lithographed, printed, stamped, or otherwise mechanically reproduced or computer-generated.

  • Patient means a person who is undergoing medical or other treatment as an in-patient in any hospital or similar institution;

  • Digital Signature means authentication of any electronic record by a subscriber by means of an electronic method or procedure in accordance with the provisions of section 3;

  • Registered Health Practitioner means a health practitioner registered, or licensed, as a health practitioner (or as a health practitioner of a particular type) under a law of a State or Territory that provides for the registration or licensing of health practitioners (or health practitioners of that type); and

  • Antipsychotic medications means that class of drugs

  • Contract Signature Page(s) means the State of Utah cover page(s) that the State Entity and Contractor sign.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79