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
