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Online medical and dental consent form

This Online Medical and Dental Consent Form is designed for medical practitioners to complete where a person is subject to a guardianship order and the Public Guardian has been appointed as their guardian.

If treatment requires the use of General Anaesthetic, please complete this Online Consent for Surgical Dental or Medical Procedure Requiring General Anaesthetic form.

If a person is under guardianship, consent for any medical procedure must be obtained from their guardian prior to any treatment (other than emergency treatment).

How to use the form
Step 1

Medical practitioner to complete the online form.

Step 2

Save form.  Print a copy for your own records

Step 3

Email completed form as an attachment to the appropriate guardian (email details are on page 2 of the form).

Step 4

Receiving guardian will fill in the relevant sections at the bottom of the form and save the pdf form.

Step 5

The guardian can email the completed pdf form as an attachment back to the medical practitioner.

Form

The Online Medical and Dental Consent Form and Online Consent for Surgical Dental or Medical Procedure Requiring General Anaesthetic have been developed as an interactive pdf.  This means you can complete the forms electronically, print, save and email as an attachment.

To access this form you should have Adobe Reader installed on your computer.  To download a copy of the free PDF reader Adobe Acrobat, click on the icon below and follow the download instructions.

get_adobe_reader Click here to download free Adobe Reader