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IVF consent form

An IVF consent form is a legal document that outlines the terms and conditions of undergoing in vitro fertilization treatment. The form should be read and signed by both the patient and the doctor prior to beginning treatment. The form should include information about the risks and potential complications of the procedure, as well as the patient's rights and responsibilities.

Time to complete

3 minutes

Eligibility

A person who is of legal age and has the mental capacity to understand the information given as well as the consequences of the procedure can fill an IVF consent form.

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Questions for IVF consent form

1.

Full name

The answer should be a text input.
2.

Date of birth

The answer should be a date input.
3.

Address

The answer should be a text input.
4.

Phone number

The answer should be a phone number.
5.

Email address

The answer should be an email input.
6.

What is your chosen treatment?

The answer should be a text input.
7.

Are you aware of the estimated cost of your chosen treatment?

The answer should be a single choice:
  1. Yes
  2. No
8.

Are you aware of the risks that are associated with the treatment you have chosen such as risks associated with the use of fertility drugs, surgical procedures, the use of assisted reproductive technologies (ART) etc.?

The answer should be a single choice:
  1. Yes
  2. No
9.

Have you been diagnosed with any medical conditions that may affect your fertility?

The answer should be a single choice:
  1. Yes
  2. No
10.

Are you taking any medication that may affect your fertility?

The answer should be a text input.
11.

Do you have any allergies that may affect your fertility treatment?

The answer should be a single choice:
  1. Yes
  2. No
12.

Do you have any religious or spiritual beliefs that may affect your fertility treatment?

The answer should be a single choice:
  1. Yes
  2. No
13.

Do you have any other concerns that you would like to discuss with us prior to treatment?

The answer should be a text input.
14.

Your signature

The answer should be a signature.

Similar Ideas

  • Egg retrieval consent form
  • Sperm retrieval consent form
  • Frozen embryo transfer consent form

Here are some FAQs and additional information
on IVF consent form

Why do I need signed consent forms?

In order to comply with the Data Protection Act 1998, you will require signed consent forms from patients who have undergone fertility treatment at your clinic. This includes any treatment which involves the use of a patient's personal data, such as maintaining a patient's medical records, or carrying out fertility treatment on a patient.

Can I use a generic consent form?

Yes, you can use a generic consent form as long as it is compliant with the Data Protection Act 1998.

Do I need to get a patient's consent every time I use their personal data?

No, you only need to get a patient's consent once. However, you will need to keep the consent form on file so that you can refer to it if you need to use the patient's personal data at a later date.

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