You will be asked to sign usually three consents. One is included below for you to review. Do not print out and complete—we will have what you need on the day of the procedure.

It is the Facility Consent entitled "Informed Consent to Treat and Disclose" (see below), which includes general information about surgery as well as privacy, disclosure and payment.

The third is not included below because it is a Procedure Specific Consent that lists the specific risks and complications of that particular surgery or procedure. In accordance with applicable State law and regulations, in the case of surgery or any other special procedure, it is the responsibility of the treating physician to inform the patient about the recommended care so that his decision may be meaningful.

This includes discussing the nature of the treatment, its risks, possible complications, expected benefits or effects, the alternatives and their risks and expected benefits, and the consequences of refusing the treatment. This process should have already taken place in the physician's office prior to the day of surgery.

The treating physician must then document the process of informed consent in the patient's medical record either on a form we provide the day of surgery or by providing us with a copy of what he used in his office setting. The Center staff will actually act as a witness to yours and the physician's signature by also signing the form.