Library of Printable Patient Consent Form Examples
We convert Hospitals Paper Form Proceesses to Automated Electronic Consent Solutions Saving time, Money and Your Hospitals Reputation.
We understand that implementing an advanced patient eSignature Platform is not always an option, so we’re here to help until you are ready. Feel free to use our library of over 70,000 printable consent examples that we have collected over the last 20 years as healthcares leading eSignature Platform. If you do not find the form you’re looking for, let us know how we can help!
About the Electronic Forms Library Project
As the leading healthcare eConsent Solution, we have collected over 70,000 (YES SEVENTY-THOUSAND) healthcare forms in the last 20 years, including an array of department specific informed consent form samples, and we want to make these examples available to healthcare organizations of all types in an effort to serve. Below you will find the quick access table of contents where we have organized over 280 of the most common hospital forms and patient consent examples by department, including polst form samples, printable HIPAA consent forms, medical procedure patient consent forms, patient intake forms, and many other patient consent forms in Spanish and English.
We feel that it is our primary directive to serve those that serve others, so if you don’t find what you’re looking for, contact us and we’ll be happy to help!
20 Years of Closing “Paper-Gaps” in Hospitals
For 20 years Access eForms has helped over 1,000 hospitals convert paper forms to EHR integrated electronic form and patient eSignature solutions. Along the way we’ve amassed quite the library of form examples from a variety of departments along the way including Patient Intake and Registration, Anesthesiology, Radiology, Obstetrics and Gynecology, Orthopaedics, and more.
We’re Here For Your Paperless Needs
Whenever you are ready to convert your paper forms to EHR integrated eForm solutions we’ve got you covered. Most commonly MEDITECH, Epic®, and Cerner hospitals leverage our solutions towards patient electronic signature capture for consents.
- Patient eSignature in Registration
- Electronic Informed Consents
- Patient At-home Consents for Telehealth
Ready to Go Paperless? We’ve Got You Covered.
ELECTRONIC FORMS LIBRARY
Table of Contents
Click to View Forms by Department
General Forms
Admission Orders
Admitting Medical Floor Treatment Orders
AUTHORIZATION TO TRANSFER
Disclosure & Consent Medical & Surgical Procedure
DISCLOSURE AND CONSENT MEDICAL AND SURGICAL PROCEDURES
FINANCIAL AGREEMENT FOR PATIENTS ENROLLED IN HEALTHCARE PLANS
ICU Admission Orders
VACCINE DOCUMENTATION CONSENT FORM
Anesthesiology Form Examples
ANESTHESIA CONSENT
ANESTHESIOLOGY CHARGE VOUCHER
ANESTHESIOLOGY PRE OPERATIVE EVALUATION
GENERAL INFORMATION FOR ANESTHESIA
HIGH RISK ANESTHESIA ASSESSMENT INSTRUCTIONS
Physician Anesthesia Orders
CONSENT FOR SURGERY, ANESTHESIA AND OTHER MEDICAL PROCEDURES
REQUEST FOR ANESTHESIA
PREOPERATIVE ANESTHESIA ASSESSMENT
Bariatric Forms
CHECKLIST FOR EGDS AND COLONOSCOPIES
CONSENT FORM (FMT) DONOR GASTRO ZENDO
CONSENT FORM (FMT) RECIPIENT Gastro ZENDO
PHYSICIAN’S ORDERS AND TREATMENTS LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING-POST-OP
POST OPERATIVE ORDERS FOR LAPAROSCOPIC GASTRIC BANDING
POST OPERATIVE ORDERS FOR LAPAROSCOPIC SLEEVE GASTRECTOMY
Post-Op Bariatric Orders
Cardiology Forms
CARDIOLOGY PROGRESS NOTE
CARDIOLOGY STRESS TEST HISTORY
CARDIOTHORACIC SURGERY CONSULTATION REPORT
CARDIOVASCULAR INFORMED CONSENT
CARDIOVERSION DISCHARGE INSTRUCTIONS
CathEP Lab Procedural Checklist and Flowsheet
ED ADMIT − CARDIAC
INFORMED CONSENT FOR CARDIAC CATHETERIZATION AND INTERVENTIONS
INVASIVE CARDIOLOGY PREPROCEDURE GENERATOR CHANGE ORDERS
SPANISH INFORMED CONSENT FOR INTERVENTIONAL CARDIOLOGY
Emergency Department Forms
CONSENT FOR EMERGENCY TREATMENT
CONSENT FOR EXAMINATION AND TREATMENT ED
ED COMPLIANCE DECLINATION SCREENING FORM
ED EMERGENCY DEPARTMENT DOCUMENT SCANNING CHECKLIST
ED QUAL CHART ED
ED TRANSFER AUTHORIZATION REFUSAL FORM
Emergency Department Assault
Emergency Department Burn
Nephrology Forms
CHP ULTRASOUND GUIDED RENAL BIOPSY (POST−BIOPSY) ORDERS
HEART TRANSPLANT ACUTE REJECTION ADMISSION ORDERS FOR ADULTS
HEMODIALYSIS PATIENT CARE ORDERS
PRE PRINTED ORDER HEPATITIS B IMMUNIZATION FOR NEPHROLOGY PATIENTS USING ENGERIX
PRE PRINTED ORDER OUT−PATIENT CHRONIC HEMODIALYSIS
RENAL TRANSPLANT OUTPATIENT LIVE DONOR RECIPIENT
ROUTINE NEPHROLOGY ASSOCIATES ORDERS
SAMSCA DOSING PROTOCOL NEPHROLOGY
Obstetrics & Gynecology Forms
DEPARTMENT OB−GYN REFUSAL OF TREATMENT SPANISH
DRUG TESTING CONSENT FORM OB – GYN
GRAPHIC CHART OBSTETRICS
GYNECOLOGICAL HISTORY
Gynecology History OBGYNHX
NURSING ADMISSION RECORD OBSTETRICS
NURSING ASSESSMENT SHORT STAY FORM
OBGYN PRACTICE GYNECOLOGICAL RECORD
RADIATION ONCOLOGY HIGH DOSE RATE BRACHYTHERAPY GYNECOLOGICAL ADMISSION ORDERS
Oncology Forms
COUMADIN FLOW-SHEET
MEDICAL ONCOLOGYHEMATOLOGY OUTPATIENT ORDER
Oncology Admission Note
Oncology Clinic Charges
ONCOLOGY OUTPATIENT CENTER MEDICATION ADMINISTRATION RECORD
ONCOLOGY PHYSICIAN’S CONSULTATION REPORT
Oncology Physician’s Progress Note
ONCOLOGY PROGRESS NOTE − INFUSION THERAPY
OUTPATIENT ONCOLOGY INITIAL REFERRAL
RADIATION ONCOLOGY CONSULTATION FORM
Ophthalmology Forms
AMBULATORY CARE PROCEDURE RECORD
OPHTHALMOLOGY RECORD RETINO
Physician’s Orders Pre and post−operative orders for Eye Surgery
SPECIAL OPHTHALMOLOGY PREMATURE
Orthopedic Forms
DISCHARGE INSTRUCTIONS − PHYSICAL THERAPY, ORTHOPEDIC
DISCHARGE INSTRUCTIONS FOOT AND ANKLE SURGERY
FOR USE WITH ORTHOPEDIC ORDER SET ONLY MEDICATION ADMINISTRATION RECORD
ORTHO TRAUMA ADMIT ORDERS
ORTHOPEDICS OUTPATIENT DISCHARGE INSTRUCTIONS
ORTHOPEDIC POST−OPERATIVE OUTPATIENT ORDERS
PHYSICAL THERAPY CHARGE SLIP
PRE PRINTED ORDER POST OPERATIVE ORTHOPAEDIC
PRE−OPERATIVE ORDERS − INPATIENT ORTHO
TRANSFER ORDERS FOR ORTHOPEDIC PATIENTS
Physiotherapy Forms
CONSENT TO RECEIVE ANTIDEPRESSANTS
MENTAL HEALTH SERVICES THERAPY ASSESSMENT (SENIOR LIFESTYLES)
PATIENT SATISFACTION QUESTIONNAIRE – THERAPY
PRE−ADMISSION SCREEN − MENTAL ILLNESS RETARDATION
RIGHTS OF INDIVIDUALS RECEIVING MENTAL HEALTH AND DEVELOPMENTAL DISABILITY SERVICES
SEDATION RECORD
Radiology Forms
ENG/SPAN AUTHORIZATION AND CONSENT TO SURGERY OR SPECIAL DIAGNOSTIC OR THERAPEUTIC PROCEDURES
INFORMED CONSENT DIAGNOSTIC PROCEDURES RADIOLOGY
INFORMED CONSENT TREATMENT OF HYPERTHYROIDISM WITH RADIOACTIVE IODINE
Interventional Radiology Nursing Flowsheet
Off-Site Physician Radiology Request
Radiology Discharge Instructions
Radiology Downtime Request
Radiology Imaging Questionnaire
Radiology MRI Safety Screen and Patient History
RADIOLOGY SPECIAL PROCEDURES NOTES
Registration & Patient Intake Forms
AUTHORIZATION TO TRANSFER
Behavioral Health General Consent – English
CONDITIONS OF SERVICES – English
CONDITIONS OF SERVICES – Spanish
General Consent 1
General Consent 2
GENERAL CONSENT FOR ADMISSION
GENERAL CONSENT FOR TREATMENT AND PATIENT AUTHORIZATION RECORD
Screening Forms
HISTORY AND PHYSICAL
Imaging Department MRI Screening Form
INFANT SCREENING RESULTS
Patient Eligibility Screening Record Vaccines for Children Program
Urology Forms
ORDER SET UROLOGY ADMISSION OR POST−OP
PRE PRINTED ORDER RADICAL PROSTATECTOMY POST−OP ORDERS FOR UROLOGY
PRE−OP UROLOGY ORDERS
SURGICAL COUNT UROLOGY
Urology Clinic Nursing Assessment
HISTORY PHYSICAL CONSULT
UROLOGY POST OPERATIVE ORDERS
