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Body Contouring Consent Form Template for United Arab Emirates

This document is a comprehensive medical consent form specifically designed for body contouring procedures in the United Arab Emirates. It complies with UAE Federal Law No. 4 of 2016 (Medical Liability Law) and relevant health authority regulations, including DHA and DOH guidelines. The form captures essential patient information, detailed procedure descriptions, risks and benefits, financial obligations, and necessary declarations while incorporating UAE-specific legal requirements for informed medical consent. It serves as both a legal record of patient consent and an educational tool ensuring patients are fully informed about their procedure.

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What is a Body Contouring Consent Form?

The Body Contouring Consent Form is a crucial document required by UAE healthcare facilities before performing any body contouring procedures. This document is designed to comply with UAE Federal Law No. 4 of 2016 and related healthcare regulations, including specific requirements from the Dubai Health Authority and Department of Health Abu Dhabi. It serves multiple purposes: documenting informed patient consent, educating patients about procedure details and risks, establishing financial responsibilities, and protecting both healthcare providers and patients. The form must be completed prior to any body contouring procedure and maintained as part of the patient's medical record, as required by UAE healthcare documentation standards.

What sections should be included in a Body Contouring Consent Form?

1. Patient Information: Patient's full legal name, Emirates ID, date of birth, contact details, and medical record number

2. Procedure Description: Detailed explanation of the specific body contouring procedure(s) to be performed, including the areas to be treated

3. Purpose and Benefits: Clear explanation of the intended outcomes and potential benefits of the procedure

4. Risks and Complications: Comprehensive list of potential risks, side effects, and complications associated with the procedure

5. Alternative Treatments: Discussion of alternative treatment options available to the patient

6. Recovery and Aftercare: Details about the expected recovery period, post-procedure care instructions, and follow-up appointments

7. Financial Responsibilities: Clear statement of costs, payment terms, and any additional fees that may arise

8. Patient Declarations: Patient's confirmation of understanding and voluntary consent, including statements required by UAE law

9. Practitioner Declaration: Medical practitioner's confirmation of explanation of procedures, risks, and answering patient questions

10. Signatures: Designated spaces for patient, practitioner, and witness signatures with dates

What sections are optional to include in a Body Contouring Consent Form?

1. Interpreter Declaration: Required when the patient's primary language is not Arabic or English, including interpreter's confirmation of accurate translation

2. Photography Consent: Optional authorization for taking and using before/after photographs for medical documentation or marketing purposes

3. Anesthesia Consent: Required when the procedure will involve general anesthesia or conscious sedation

4. Medical History: Detailed medical history section may be separated into a different form or included based on facility requirements

5. Revision Policy: Optional section detailing the facility's policy on revision procedures or touch-ups

6. Cancellation Policy: Optional section outlining the terms and conditions for cancelling or rescheduling the procedure

What schedules should be included in a Body Contouring Consent Form?

1. Procedure Details: Detailed technical description of the specific procedure(s) to be performed, including treatment areas marked on body diagrams

2. Pre-operative Instructions: Comprehensive list of preparations required before the procedure

3. Post-operative Care Guide: Detailed instructions for post-procedure care and recovery

4. Medical History Form: Detailed questionnaire about patient's medical history, current medications, and allergies

5. Price Schedule: Breakdown of costs associated with the procedure, including any potential additional fees

6. Before/After Photo Documentation: Standardized photography documentation forms and consent

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

Publisher

Genie AI

Document Type

Consent Form

Cost

Free to use

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