51��Ƶ����

The Refusal Consent Form is a critical document in Indian healthcare settings, designed to protect both healthcare providers and patients when medical treatment is declined. It is required whenever a patient refuses recommended medical intervention, ensuring compliance with Indian Medical Council Regulations, the Consumer Protection Act, and constitutional rights to personal autonomy. The form documents the nature of refused treatment, risks of refusal, alternative options discussed, and confirms the patient's informed decision-making capacity. It becomes particularly important in cases involving serious medical conditions, emergency situations, or when dealing with vulnerable patients, serving as a legal record of the patient's exercise of their right to refuse treatment.

1. Patient Information: Patient's full name, age, ID numbers, contact details, and medical record number

2. Healthcare Provider Information: Name and details of the healthcare facility and treating physician(s)

3. Treatment/Procedure Details: Clear description of the medical treatment, procedure, or intervention being refused

4. Reason for Recommendation: Medical explanation of why the treatment was recommended and its intended benefits

5. Risks of Refusal: Detailed explanation of the potential consequences and risks of refusing the recommended treatment

6. Patient Acknowledgment: Statement confirming the patient understands the risks and consequences of refusal

7. Alternative Options: Description of any alternative treatments discussed and available to the patient

8. Declaration: Formal statement of refusal and confirmation that the decision is made voluntarily

9. Signatures: Space for patient/guardian signature, witness signature, and healthcare provider signature