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1. Parties: Identification of the healthcare provider/facility and the patient/client, including full legal names and relevant contact information
2. Background: Context of the medical treatment or services being provided and the purpose of the waiver
3. Definitions: Clear definitions of key terms used in the waiver, including 'Medical Services', 'Treatment', 'Healthcare Provider', 'Liability', etc.
4. Acknowledgment of Risks: Detailed acknowledgment of the inherent risks associated with medical procedures or treatments
5. Voluntary Participation: Statement confirming that the patient is voluntarily participating in the medical treatment or services
6. Release of Liability: Explicit waiver of liability for specified risks and outcomes, clearly stating what claims are being waived
7. Medical Consent: Express consent for the specified medical procedures or treatments
8. Emergency Authorization: Authorization for emergency medical treatment if necessary
9. Insurance Responsibility: Clarification of responsibility for medical costs and insurance coverage
10. Governing Law: Specification of applicable Canadian provincial law governing the agreement
11. Severability: Clause stating that if any portion is found invalid, the remainder stays in effect
12. Signature Block: Space for dated signatures of all parties, including witnesses if required
1. Specific Medical Conditions: Additional section for patients with pre-existing conditions that may affect treatment
2. Photography Consent: Optional consent for medical photography or documentation
3. Research Participation: For cases where medical data may be used in research
4. Third Party Authorization: For cases involving guardians or authorized decision-makers
5. Translation Certificate: For documents provided in multiple languages or requiring translation
6. Pregnancy Disclaimer: Special provisions for pregnant patients where applicable
7. Mental Capacity Declaration: Additional section confirming patient's mental capacity to understand and consent
1. Schedule A - Specific Procedures: Detailed description of medical procedures covered by the waiver
2. Schedule B - Known Risks: Comprehensive list of known risks and potential complications
3. Schedule C - Pre-existing Conditions: Documentation of relevant pre-existing medical conditions
4. Appendix 1 - Emergency Contacts: List of emergency contacts and their authorization levels
5. Appendix 2 - Facility Policies: Relevant facility policies and procedures referenced in the main agreement
6. Appendix 3 - Post-Treatment Instructions: Detailed instructions for post-treatment care and follow-up
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