1. Interpreter Declaration: Required when the patient's primary language is not the language used in the form

2. Guardian Authorization: Required when the patient is a minor or legally incapable of providing consent

3. Special Medical Conditions: Additional section for documenting any relevant pre-existing conditions or allergies

4. Photography/Recording Consent: Optional authorization for medical photography or recording during the procedure

5. Research Participation: Required when the procedure is part of a medical research study

6. Blood Transfusion Specific Consent: Required for procedures that may require blood transfusion

7. Religious or Cultural Considerations: Special instructions based on patient's religious or cultural requirements

1. Appendix A - Procedure Details: Detailed medical description of the procedure including technical aspects and duration

2. Appendix B - Risk Disclosure: Comprehensive list of potential risks and complications with statistical data

3. Appendix C - Post-Procedure Care: Detailed instructions for post-procedure care and recovery

4. Appendix D - Emergency Contacts: List of emergency contact numbers and healthcare providers

5. Appendix E - Cost Breakdown: Detailed breakdown of procedure costs and insurance coverage details

6. Appendix F - Medical Terms Glossary: Definitions of medical terms used in the main document