Dear costumers,
* Signing the consent forms is the final step in obtaining informed consent for medical treatment.
* Please maintain clear writing and make sure to fill in all the details.
General surgery consent form >> Hebrew | English | Russian | Arabic
Request form to be accepted at Medica >> Hebrew | English | Russian
Consent form for invasive treatment and/or surgery during COVID-19 pandemic >> Hebrew | English | Russian | Arabic
Health questionnaire form >> Hebrew | English | Russian | Arabic
Anesthesia:
Consent form: anesthesia >> Hebrew | English | Russian | Arabic
Orthopedics:
Consent form: release of trigger finger >> Hebrew | English | Russian | Arabic
Consent form: release of carpal tunnel syndrome (CTS), release of Ulnar nerve – Guyon’s canal >> Hebrew | English | Russian | Arabic
Consent form: surgery for excision of ganglion >> Hebrew | English | Russian | Arabic
Consent form: surgery for repair of flexor/extensor tendons >> Hebrew | English | Russian | Arabic
Consent form: Arthroscopy of the shoulder >> Hebrew | English | Russian | Arabic
Ophthalmology:
Consent form: surgery for extraocular muscles >> Hebrew | English | Russian
Consent form: surgery for Pterygium removal >> Hebrew | English | Russian | Arabic
Consent form: eyelid surgery – Blepharoplasty >> Hebrew | English | Russian | Arabic
Consent form: surgery for cataract extraction>> Hebrew | English | Russian | Arabic
Consent form: surgery for cataract extraction with laser >> Hebrew | English | Russian | Arabic
Consent form: YAG laser treatment to open secondary cataract >> Hebrew | English | Russian | Arabic
Consent form: SLT laser treatment for Glaucoma disease >> Hebrew | Russian | Arabic
Consent form: Vitrectomy with/without repair of retinal detachment >> Hebrew | English | Russian | Arabic
Consent form: Trabeculectomy surgery for Glaucoma patients >> Hebrew | English | Russian | Arabic
Consent form: surgery for repair of retinal detachment >> Hebrew | English | Russian | Arabic
Consent form: Collagen cross-linking treatment >> Hebrew | English | Russian | Arabic
Consent form: intra-vitreal injection >> Hebrew | English | Russian | Arabic
Consent form: retinal laser treatment >> Hebrew | English | Russian | Arabic
Consent form: Entropion surgery >> Hebrew | English | Russian | Arabic
Consent form: Ectropion surgery >> Hebrew | English | Russian | Arabic
Consent form: surgery for frontalis sling operation >> Hebrew | English | Russian | Arabic
Consent form: surgery for upper eyelid ptosis repair >> Hebrew | English | Russian | Arabic
Consent form: surgery for Corneal transplantation >> Hebrew | English | Russian | Arabic
Consent form: DCR surgery for reconstruction of the lacrimal system with or without stenting >> Hebrew | English | Russian | Arabic
Consent form: Dacryocystorhinostomy with or without silicone stenting >> Hebrew
Consent form: surgery for incision and drainage of Chalazion >> Hebrew | English | Russian | Arabic
Consent form: surgery for eyelid lesion removal and eyelid reconstruction >> Hebrew | English | Russian | Arabic
MOHS:
Consent form: surgery for removal of cutaneous lesion >> Hebrew | English | Russian | Arabic
Consent form: MOHS micrographic surgery >> Hebrew | Russian | English | Arabic
EEG:
Consent form: Adenoidectomy/Tonsillectomy >> Hebrew | English | Russian | Arabic
Consent form: surgery for introduction of ventilating tubes (VT) >> Hebrew | Russian | Arabic
Consent form: Functional Endoscopic Sinus Surgery (FESS) >> Hebrew | English | Russian | Arabic
Consent form: surgery for Lingual Frenectomy >> Hebrew | English | Russian | Arabic
Consent form: SMR/Septoplasty and/or Conchotomy/turbinate reduction >> Hebrew | English | Russian | Arabic
Consent form: surgery for middle ear cavity exploration and hearing rehabilitation using a prosthesis >> Hebrew | English | Russian | Arabic
Consent form: Tympanoplasty/Ossiculoplasty >> Hebrew | English | Russian | Arabic
Consent form: Mastoidectomy surgery >> Hebrew | English | Russian | Arabic
Gynecology:
Consent form: Diagnostic/therapeutic Hysteroscopy >> Hebrew | English | Russian | Arabic
Consent form: insertion of IUD >> Hebrew | English | Russian | Arabic
Consent form: Hysterography >> Hebrew | English | Russian | Arabic
Consent form: vacuum/curettage of uterus for termination of pregnancy D&C >> Hebrew | English | Russian | Arabic
Consent form: Amniocentesis for genetic diagnosis >> Hebrew | English | Russian | Arabic
Consent form: Hysterosal Ringosonography >> English | English | Russian | Arabic
Surgery:
Consent form: surgery for open repair of Inguinal Hernia >> Hebrew | English | Russian | Arabic
Consent form: surgery for repair of Umbilical Hernia >> Hebrew | English | Russian | Arabic
Consent form: Orchiopexy (Undescended Testis) >> Hebrew | English | Russian | Arabic
Consent form: medical circumcision >> Hebrew | English | Russian | Arabic
Consent form: surgery for repair of anal fissure >> Hebrew | English | Russian | Arabic
Consent form: Hemorrhoidectomy/Stapled Hemorrhoidectomy/ Hemorrhoidal artery/ Hemorrhoid laser procedure >> Hebrew | English | Russian | Arabic
Consent form: chemical skin peel (Exfoliation) >> Hebrew | English | Russian | Arabic
Plastic surgery:
Consent form: Rhinoplasty >> Hebrew | English | Russian
Consent form: Otoplasty >> Hebrew | English | Russian | Arabic
Consent form: Mastopexy >> Hebrew | English | Russian | Arabic
Consent form: Breast reduction >> Hebrew | English | Russian | Arabic
Consent form: Breast augmentation >> Hebrew | English | Russian | Arabic
Consent form: Liposuction >> Hebrew | English | Russian | Arabic
Consent form: Abdominoplasty >> Hebrew | English | Russian | Arabic
Consent form: Facelift >> Hebrew | English | Russian | Arabic
Consent form: Labiaplasty >> Hebrew | English | Russian | Arabic
Consent form: Gynecomastia surgery >> Hebrew | English | Russian | Arabic
Consent form: surgery for breast implant extraction >> Hebrew | English | Russian | Arabic
Consent form: surgery for lower/upper body contouring weight loss >> Hebrew | English | Russian | Arabic
Vascular surgery:
Consent form: Sclerotherapy treatment >> Hebrew | English | Russian | Arabic
Consent form: Endovenous radio – frequency ablation treatment >> Hebrew | English | Russian | Arabic
Consent form: Endovenous laser for varicose veins treatment >> Hebrew | English | Russian | Arabic
Urology:
Consent form: Ureteroscopy >> Hebrew | English | Arabic
Consent form: Cystoscopy >> Hebrew | Russian | Arabic
Consent form: Needle Biopsy/Core Needle Biopsy of the prostate gland >> Hebrew | Russian | Arabic
Consent form: surgery for stress incontinence repair >> Hebrew | English | Russian | Arabic
Back pain:
Consent form: R.F. radio wave treatment >> Hebrew | English | Russian | Arabic
Consent form: selective nerve roots injection under fluoroscopic guidance >> Hebrew | English | Russian | Arabic
General forms:
Treatment summary form >> Hebrew | English | Russian | Arabic
Surgery report form >> Hebrew | English | Russian | Arabic
Payment report for usage of intra-surgical equipment >> Hebrew | English | Russian | Arabic
Anesthesia release form >> Hebrew | English | Russian | Arabic
Referral of patient for surgery/treatment at Medica – Medical Centers >> Hebrew | English | Russian | Arabic
Consent form of a parent not present at the hospital for treatment of a minor (non-routine treatment) >> Hebrew | English | Russian | Arabic