Permission To Treat Form for Nigeria

Permission To Treat Form Template for Nigeria

A Permission to Treat Form is a legally binding document used in Nigerian healthcare settings that establishes informed consent between a healthcare provider and a patient or their legal representative. The document complies with the National Health Act 2014 and related Nigerian healthcare regulations, documenting the patient's voluntary agreement to receive medical treatment, procedures, or examinations. It includes detailed information about the proposed treatment, potential risks and benefits, alternative options, and financial responsibilities, while ensuring patient rights are protected under Nigerian law.

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What is a Permission To Treat Form?

The Permission to Treat Form is a fundamental document in Nigerian healthcare settings, required under the National Health Act 2014 and regulated by the Medical and Dental Practitioners Act. This form serves as both a legal record of informed consent and a communication tool between healthcare providers and patients. It is mandatory before administering any significant medical treatment, except in emergency situations where immediate intervention is necessary to preserve life or prevent serious harm. The document must be completed prior to treatment and includes comprehensive information about the proposed medical intervention, risks, benefits, and alternatives, while also capturing crucial patient information and emergency contacts. The form should be available in English and, where necessary, translated into local languages to ensure proper understanding and valid consent.

What sections should be included in a Permission To Treat Form?

1. Patient Information: Essential patient details including full name, date of birth, address, contact information, and hospital/medical record number

2. Healthcare Provider Information: Details of the hospital/clinic, attending physician(s), and department providing treatment

3. Consent Declaration: Clear statement that the patient (or legal representative) gives consent for medical treatment and understands their rights

4. Scope of Treatment: Description of the medical procedures, treatments, or examinations being consented to

5. Risks and Benefits: Overview of potential risks, complications, benefits, and alternative treatments available

6. Financial Responsibility: Acknowledgment of financial obligations and payment arrangements

7. Signatures: Dedicated section for patient/guardian signature, witness signature, and healthcare provider signature with dates

What sections are optional to include in a Permission To Treat Form?

1. Emergency Contact Information: Section for emergency contact details - recommended for ongoing or long-term treatment consent

2. Interpreter Declaration: Required when consent discussions are conducted through an interpreter

3. Photography Consent: Optional section for consent to photograph or record procedures for medical documentation

4. Research Participation: Optional section for consent to use treatment data for research purposes

5. Blood Transfusion Specific Consent: Additional section required when blood transfusion might be necessary

6. Religious or Cultural Considerations: Section to document any specific religious or cultural requirements affecting treatment

What schedules should be included in a Permission To Treat Form?

1. Schedule A - Detailed Procedure Description: Detailed technical description of specific procedures or treatments being consented to

2. Schedule B - Patient Rights and Responsibilities: Comprehensive list of patient rights and responsibilities under Nigerian healthcare law

3. Schedule C - Hospital Policies: Relevant hospital policies affecting patient care and treatment

4. Appendix 1 - Medical Terms Glossary: Definitions of medical terms used in the consent form in plain language

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

Nigeria

Publisher

Genie AI

Document Type

Consent Form

Cost

Free to use
Relevant legal definitions
Relevant Industries

Healthcare

Medical Services

Hospital Administration

Emergency Medical Services

Primary Care

Specialized Medical Care

Mental Health Services

Pediatric Care

Dental Services

Public Health

Private Healthcare

Relevant Teams

Legal

Compliance

Medical Records

Patient Administration

Risk Management

Quality Assurance

Clinical Operations

Patient Relations

Emergency Services

Admissions

Relevant Roles

Medical Director

Hospital Administrator

Physician

Surgeon

Nurse Manager

Legal Compliance Officer

Risk Management Officer

Patient Relations Manager

Medical Records Officer

Quality Assurance Manager

Healthcare Facility Manager

Clinical Operations Director

Emergency Department Director

Admissions Manager

Patient Safety Officer

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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