1. Religious or Cultural Preferences: Special instructions regarding treatment restrictions based on religious or cultural beliefs

2. Advance Directives Reference: Reference to any existing advance directives or living will, if applicable

3. Specific Treatment Exclusions: List of specific treatments or procedures the patient does not consent to

4. Language Preference: Preferred language for communication and need for interpreter services

5. Guardian Information: Details of legal guardian or representative for minors or individuals lacking capacity

6. Medical Device Information: Information about any medical devices, implants, or prosthetics

1. Appendix A - Medical History Form: Detailed medical history form including past surgeries, conditions, and medications

2. Appendix B - Insurance Information: Detailed insurance policy information and coverage details

3. Appendix C - Specific Procedure Consents: Additional consent forms for specific high-risk procedures

4. Appendix D - Hospital Policies: Summary of relevant hospital policies regarding emergency treatment

5. Appendix E - Patient Rights: Document outlining patient rights under Philippine healthcare laws