Consent Forms

Certain procedures or tests require particular forms of patient consent. You can access those consent forms here.

• Consent to Medical Treatment via Remote Communication Technology (English, Form 32716, Rev 4/20)
• Consentimiento para Tratamiento Médico por Tecnología de Comunicación Remota (Spanish, Form 32688, Rev 1/20)
  
  
• In Loco Parentis Consent to Treat and Affidavit (Forms 31646 and 32179, Rev 6/20 and 7/18)
  
  
• Parent / Guardian’s Consent for Treatment, Information Sharing, and Financial Agreement (Form 31647, Rev 5/20)
• Adult Patient Consent for Treatment, Information Sharing, and Financial Agreement (English, Form 31648, Rev 8/19)
• Consentimiento de paciente adulto para tratamiento, divulgación de información y acuerdo de pago (Adult Patient Consent) (Spanish, Form 31666, Rev 1/17)