Medical Treatment Authorisation Form Template for England and Wales

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Key Requirements PROMPT example:

Medical Treatment Authorisation Form

"I need a Medical Treatment Authorisation Form for a private dental clinic in Cardiff that performs complex orthodontic procedures, ensuring compliance with Welsh health regulations and including specific provisions for treatment of patients under 16."

Document background
The Medical Treatment Authorisation Form serves as a crucial documentation tool in healthcare settings across England and Wales. It is required whenever a patient undergoes significant medical procedures or treatments, ensuring compliance with legal requirements for informed consent. The form documents the patient's understanding of the proposed treatment, associated risks, and alternatives, while protecting both patient autonomy and healthcare provider liability. It must be completed in accordance with the Mental Capacity Act 2005, Data Protection Act 2018, and relevant NHS guidelines, particularly in cases involving complex procedures, research participation, or where capacity might be in question.
Suggested Sections

1. Patient Information: Personal details, NHS number, contact information and relevant medical history

2. Healthcare Provider Details: Institution name, treating physician information, department and contact details

3. Proposed Treatment: Detailed description of medical procedure/treatment including purpose and expected outcomes

4. Risks and Benefits: Clear outline of potential outcomes, risks, side effects and expected benefits of the treatment

5. Consent Declaration: Patient's explicit consent statement including confirmation of understanding and voluntary agreement

6. Signatures: Signature sections for patient/guardian and healthcare provider with date and time fields

Optional Sections

1. Emergency Contact: Secondary contact details for high-risk procedures or extended treatments

2. Interpreter Declaration: Confirmation of accurate translation when patient requires language assistance

3. Mental Capacity Assessment: Documentation of capacity evaluation when patient's capacity may be in question

4. Parent/Guardian Authorization: Additional consent section for minors or those lacking capacity

Suggested Schedules

1. Treatment Protocol: Detailed medical procedure guidelines and specifications

2. Post-Treatment Care Plan: Recovery instructions, follow-up appointments and post-treatment care guidelines

3. Alternative Treatment Options: Comprehensive list of other available treatments and their implications

4. Patient Information Leaflet: Supplementary information about the medical condition and proposed treatment

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

Relevant legal definitions
Clauses
Industries

Mental Capacity Act 2005: Primary legislation governing capacity assessment, best interests decision-making, advance decisions, and Lasting Powers of Attorney for health and welfare

Human Rights Act 1998: Ensures compliance with fundamental rights including right to life (Article 2), freedom from inhuman treatment (Article 3), and right to privacy (Article 8)

Data Protection Act 2018 and UK GDPR: Governs the processing of special category health data, information sharing, confidentiality, and record keeping requirements

Care Act 2014: Covers safeguarding provisions, consent requirements, and integration of care and support with health services

Common Law principles: Establishes fundamental principles of informed consent, duty of care, and medical negligence considerations

NHS Act 2006: Defines rights and responsibilities within NHS treatment and emergency treatment provisions

Equality Act 2010: Ensures non-discrimination in treatment decisions and provision for reasonable adjustments

Children Act 1989: Governs medical treatment for minors, including parental responsibility, best interests principle, and Gillick competence considerations

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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