The Surgical Consent Form is a critical legal and medical document required by UAE healthcare regulations before performing any surgical procedure. This document serves as evidence of informed consent and must comply with Federal Law No. 4 of 2016 on Medical Liability, as well as specific emirate-level health authority requirements. The form must be provided in both Arabic and English, and includes comprehensive information about the proposed surgery, its risks, benefits, and alternatives. It is designed to protect both healthcare providers and patients by ensuring clear communication and documentation of the consent process. The Surgical Consent Form is mandatory for all surgical procedures performed in UAE healthcare facilities and must be completed before any surgical intervention can take place. It requires various elements including patient identification, procedure details, risk disclosures, and appropriate signatures from all relevant parties.

1. Patient Information: Patient's full name, Emirates ID, date of birth, medical record number, and contact details

2. Healthcare Facility Details: Name and details of the hospital/clinic where the procedure will be performed

3. Procedure Information: Detailed description of the proposed surgical procedure, including its medical name and layman's terms explanation

4. Purpose and Benefits: Clear explanation of why the procedure is necessary and its expected benefits

5. Risks and Complications: Comprehensive list of potential risks, complications, and side effects associated with the procedure

6. Alternative Treatments: Description of alternative treatment options and consequences of not proceeding with the surgery

7. Anesthesia Consent: Specific consent for anesthesia, including type and associated risks

8. Blood Transfusion Consent: Consent for potential blood transfusion during surgery if needed

9. Patient Acknowledgment: Patient's confirmation of understanding and opportunity to ask questions

10. Declarations: Formal statements confirming voluntary consent and understanding of all information provided

11. Signatures: Signature blocks for patient/guardian, surgeon, anesthesiologist, and witness