Medical Liability Waiver Form Template for Belgium

1. Language Declaration: Required when the patient's primary language is not the language of the document, confirming translation provisions

2. Specific Medical Conditions: Additional section for patients with pre-existing conditions that may affect treatment

3. Insurance and Payment: Required when the waiver includes provisions about insurance coverage and payment responsibilities

4. Research Participation: Required when the medical procedure involves research or experimental treatment

5. Photography Consent: Optional section for consent to photograph or record the procedure for medical documentation

6. Student/Observer Presence: Required when medical students or observers may be present during treatment

1. Schedule A - Detailed Procedure Description: Technical description of the medical procedure(s) in medical terminology

2. Schedule B - Risk Disclosure: Comprehensive list of all potential risks and complications with statistical information where available

3. Schedule C - Patient Information Leaflet: Simplified explanation of the procedure and aftercare instructions

4. Appendix 1 - Hospital Policies: Relevant hospital or facility policies that affect patient care

5. Appendix 2 - Emergency Contacts: List of emergency contacts and relevant medical staff

6. Appendix 3 - Language Versions: Translations of the waiver in relevant Belgian official languages (French, Dutch, German) if required