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Refusal Consent Form

Refusal Consent Form Template for Hong Kong

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Key Requirements PROMPT example:

Refusal Consent Form

"I need a Refusal Consent Form for use in our private Hong Kong clinic, specifically for patients refusing non-emergency surgical procedures, with additional sections for interpreter declarations as we serve many non-English/Chinese speaking patients."

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Document background
The Refusal Consent Form is a critical document in Hong Kong's healthcare system, designed to protect both patients' rights and healthcare providers' interests. It is used when a patient decides to decline recommended medical treatment, procedures, or interventions after being fully informed of the potential consequences. The form must comply with Hong Kong's Personal Data (Privacy) Ordinance, Hospital Authority guidelines, and common law principles regarding medical consent. It typically includes detailed patient information, specific treatment being refused, acknowledgment of risks, and confirmation of mental capacity. This document is particularly important in situations where standard medical procedures are declined, ensuring that the refusal is properly documented and legally valid within Hong Kong's jurisdiction.
Suggested Sections

1. Patient Information: Full legal name, ID number, contact details, and other identifying information of the patient

2. Healthcare Provider Details: Name and details of the hospital/clinic and healthcare provider(s) involved

3. Treatment/Procedure Description: Detailed description of the medical treatment or procedure being refused

4. Declaration of Refusal: Clear statement of refusal of the specified treatment/procedure

5. Acknowledgment of Risks: Statement acknowledging the potential consequences and risks of refusing treatment

6. Confirmation of Information: Confirmation that the patient has received and understood all relevant information about the treatment and consequences of refusal

7. Signature Block: Space for patient signature, date, and witness signatures

Optional Sections

1. Interpreter Declaration: Required when the patient's primary language is not English or Chinese, confirming that the contents have been properly translated

2. Mental Capacity Assessment: Required when there are concerns about the patient's mental capacity to make the decision

3. Alternative Treatment Options: Optional section listing alternative treatments the patient may consider

4. Substitute Decision Maker: Required when the patient is unable to make decisions and a legal representative is acting on their behalf

5. Religious or Cultural Grounds: Optional section for documenting specific religious or cultural reasons for treatment refusal

Suggested Schedules

1. Medical Information Sheet: Detailed information about the refused treatment/procedure and its medical implications

2. Risk Assessment Form: Comprehensive list of potential risks and consequences of refusing treatment

3. Patient Rights Information: Document outlining patient rights regarding treatment refusal in Hong Kong

4. Healthcare Provider Notes: Documentation of discussions between healthcare provider and patient regarding the refusal

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions
























Clauses


















Relevant Industries

Healthcare

Medical Services

Hospital Administration

Legal Services

Insurance

Elder Care

Mental Health Services

Emergency Medical Services

Private Clinical Practice

Public Health

Relevant Teams

Legal

Compliance

Medical Records

Patient Relations

Risk Management

Quality Assurance

Clinical Operations

Medical Administration

Documentation

Ethics Committee

Relevant Roles

Medical Doctor

Nurse

Hospital Administrator

Legal Counsel

Risk Manager

Patient Relations Officer

Medical Records Officer

Compliance Officer

Healthcare Facility Manager

Clinical Director

Quality Assurance Manager

Medical Secretary

Healthcare Documentation Specialist

Patient Care Coordinator

Ethics Committee Member

Industries





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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