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1. Patient Information: Patient's full legal name, Emirates ID, date of birth, contact details, and medical record number
2. Procedure Description: Detailed explanation of the specific body contouring procedure(s) to be performed, including the areas to be treated
3. Purpose and Benefits: Clear explanation of the intended outcomes and potential benefits of the procedure
4. Risks and Complications: Comprehensive list of potential risks, side effects, and complications associated with the procedure
5. Alternative Treatments: Discussion of alternative treatment options available to the patient
6. Recovery and Aftercare: Details about the expected recovery period, post-procedure care instructions, and follow-up appointments
7. Financial Responsibilities: Clear statement of costs, payment terms, and any additional fees that may arise
8. Patient Declarations: Patient's confirmation of understanding and voluntary consent, including statements required by UAE law
9. Practitioner Declaration: Medical practitioner's confirmation of explanation of procedures, risks, and answering patient questions
10. Signatures: Designated spaces for patient, practitioner, and witness signatures with dates
1. Interpreter Declaration: Required when the patient's primary language is not Arabic or English, including interpreter's confirmation of accurate translation
2. Photography Consent: Optional authorization for taking and using before/after photographs for medical documentation or marketing purposes
3. Anesthesia Consent: Required when the procedure will involve general anesthesia or conscious sedation
4. Medical History: Detailed medical history section may be separated into a different form or included based on facility requirements
5. Revision Policy: Optional section detailing the facility's policy on revision procedures or touch-ups
6. Cancellation Policy: Optional section outlining the terms and conditions for cancelling or rescheduling the procedure
1. Procedure Details: Detailed technical description of the specific procedure(s) to be performed, including treatment areas marked on body diagrams
2. Pre-operative Instructions: Comprehensive list of preparations required before the procedure
3. Post-operative Care Guide: Detailed instructions for post-procedure care and recovery
4. Medical History Form: Detailed questionnaire about patient's medical history, current medications, and allergies
5. Price Schedule: Breakdown of costs associated with the procedure, including any potential additional fees
6. Before/After Photo Documentation: Standardized photography documentation forms and consent
Treatment Area
Provider
Practitioner
Patient
Informed Consent
Medical Facility
Complications
Post-operative Care
Recovery Period
Adverse Events
Revision Procedure
Before and After Photography
Medical Record
Treatment Plan
Anesthesia
Local Anesthesia
General Anesthesia
Witness
Guardian
Interpreter
Healthcare Authority
Emergency Care
Follow-up Care
Side Effects
Expected Results
Material Risks
Alternative Treatments
Pre-operative Instructions
Post-operative Instructions
Healing Period
Consulting Physician
Operating Physician
Medical Assessment
Surgical Marking
Contractual Obligations
Liability
Consent Withdrawal
Medical Tourism
Force Majeure
Medical History
Procedure Description
Risks and Complications
Consent and Authorization
Financial Terms
Confidentiality
Photography Consent
Emergency Procedures
Patient Rights
Medical Records
Treatment Plan
Post-Procedure Care
Follow-up Requirements
Liability and Indemnification
Termination Rights
Privacy and Data Protection
Documentation Requirements
Language and Translation
Governing Law
Dispute Resolution
Force Majeure
Amendments and Modifications
Severability
Acknowledgment and Declaration
Healthcare
Medical Tourism
Cosmetic Surgery
Aesthetic Medicine
Plastic Surgery
Medical Services
Beauty and Wellness
Legal
Compliance
Medical Records
Patient Services
Quality Assurance
Risk Management
Clinical Operations
Administrative Services
Document Control
Plastic Surgeon
Cosmetic Surgeon
Medical Director
Clinic Manager
Legal Compliance Officer
Patient Care Coordinator
Medical Records Manager
Quality Assurance Manager
Healthcare Administrator
Risk Management Officer
Consent Coordinator
Medical Legal Advisor
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