Consent
No. |
Title |
Rev Date |
| 202860 |
Blood Transfusion Consent |
09/01/11 |
| 301005 |
Consent for HIV Antibody Test |
10/17/11 |
| 356978 |
Consent for Surgery |
01/15/11 |
| 356979 |
Consent for Procedure/Treatment |
01/15/11 |
| 356980 |
Consent For Anesthesia |
01/15/11 |
| 586000 |
Cardiac Rehabilitation Patients Informed Consent |
07/11/11 |
| 596494 |
Verbal Release of Information Consent |
01/26/11 |
| 596558 |
Family Birth Center Consent form Hepatitis B |
01/26/11 |
| 597006 |
Family Birth Center Placent Release Consent |
01/21/11 |
| 597009 |
Record For Medical, Educational Scientific Purposes Consent To Photograph And/Or |
01/21/11 |
| 597069 |
Gestation At St. Elizabeth Hospital Consent to Deliver at 35-36 Weeks |
01/21/11 |
| 597106 |
Post Operative care, Medical Treatment, Anesthesia, or Other Procedure Special Consent to Operation |
01/21/11 |
| 597113 |
IV Tissue Plasminogen Activator - t-PA Consent for Administration Of |
01/21/11 |
| 597115 |
Fistulagram Consent for Procedure and Treatment |
10/18/11 |
| 597116 |
Insertion of Patent Foramen Ovale/Atrial Septal Defect Closure Device Consent for Procedure/Treatment |
10/18/11 |
| 597117 |
Transesophageal Echocardiogram Consent for Procedure/Treatment |
10/18/11 |
| 597118 |
Liver Biopsy Consent for Procedure/Treatment |
10/18/11 |
| 597119 |
Renal Failure Consent for Procedure/Treatment |
10/18/11 |
| 597120 |
Carotid Angiography With/Without Stent Consent for Procedure/Treatment |
10/18/11 |
| 597121 |
Intra Aortic Balloon Consent for Procedure/Treatment |
10/18/11 |
| 597122 |
Insertion of Permanent Pacemaker Consent for Procedure/Treatment |
10/18/11 |
| 597123 |
Insertion of Temporary Pacemaker Consent for Procedure/Treatment |
10/12/11 |
| 597124 |
Cardioversion Consent for Procedure/Treatment |
10/18/11 |
| 597125 |
Treadmill Consent for Procedure/Treatment |
10/18/11 |
| 597126 |
Defibrillation Threshold Testing Consent for Procedure/Treatment |
10/18/11 |
| 597127 |
Insertion Of Cardiac Resychronization Biventicular Pacemaker Defibrillator (CRT-D) Consent for Procedure/Treatment |
10/19/11 |
| 597128 |
Insertion of Implantable Cardioverter Defibrillator (ICD) Consent for Procedure/Treatment |
10/19/11 |
| 597129 |
Insertion Of Cardiac Resynchronization Biventricular Pacemaker (CRT-P) Consent for Procedure/Treatment |
10/19/11 |
| 597130 |
Electrophysiology Study With Possible Radiofrequency Catheter Ablation Consent for Procedure/Treatment |
10/19/11 |
| 597131 |
Head Up Tilt Table Study Consent for Procedure/Treatment |
10/19/11 |
| 597132 |
Intravenous T.P.A Consent for Procedure/Treatment |
10/19/11 |
| 597133 |
Chest Tube Insertion Consent for Procedure/Treatment |
10/19/11 |
| 597134 |
Central Line Insertion Consent for Procedure/Treatment |
10/19/11 |
| 597135 |
Bronchoscopy Consent for Procedure/Treatment |
03/01/12 |
| 597136 |
Heart Valve Consent for Surgery |
10/19/11 |
| 597137 |
Coronary Artery Bypass Consent for Surgery |
10/19/11 |
| 597139 |
Pregnancy- Cesarean Section Consent for Surgery |
10/19/11 |
| 597140 |
Pregnancy- Vaginal Delivery Consent for Procedure/Treatment |
10/19/11 |
| 597141 |
Colonoscopy Consent for Procedure/Treatment |
10/11/11 |
| 597143 |
Discogram Consent for Procedure/Treatment |
10/19/11 |
| 597144 |
Endoscopic Retrograde Cholangiopancreatography (ERCP) Consent for Procedure/Treatment |
10/19/11 |
| 597145 |
Upper Endoscopy (EGD) Consent for Procedure/Treatment |
10/11/11 |
| 597146 |
Endoscopic Ultrasound (EUS) Consent for Procedure/Treatment |
10/19/11 |
| 597147 |
Epidural Pain Block Injection Consent for Procedure/Treatment |
01/26/11 |
| 597148 |
Interventional Bronchoscopy Consent for Procedure Treatment |
10/19/11 |
| 597154 |
Loop Recorder Consent for Procedure/Treatment |
10/19/11 |
| 597155 |
Peripheral Angiography, Angioplasty With/Without Stent Consent for Procedure/Treatment |
10/19/11 |
| 597156 |
Cardiac Catheterization, PTCA with/without Stent Consent for Procedure/Treatment |
10/11/11 |
| 597157 |
Cardiac Catheterization, PTCA With/Without Stent St. Francis Hospital Consent for Procedure/Treatment |
10/19/11 |
| 597159 |
Strabismus Consent for Surgery |
10/19/11 |
| 597160 |
Cataract Consent for Surgery |
10/19/11 |
| 597161 |
Yag Laser Consent for Surgery |
10/19/11 |
| 597162 |
Laser Trabeculoplasty Consent for Surgery |
10/19/11 |
| 597187 |
Lexiscan Consent for Procedure/Treatment |
08/11/11 |
| 597196 |
Gandolinium Based MR Contrast Agents Diagnostic Imaging Consent for Administration |
05/12/11 |
| 597247 |
Consent for Anesthesia (Spanish) |
03/30/12 |
| 597248 |
Consent for Procedure/Treatment (Spanish) |
03/30/12 |
| 597249 |
Consent for Surgery (Spanish) |
03/30/12 |
