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Sample Checklist: Support Process for Informed Consent

Are you "fit" for success? Complete this RiskFit® Checklist and see!

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Question 1 of 5

Do you verify that patients or clients have an understanding of the risks and benefits of any procedure you are involved in or performing?

A

Yes

B

No

C

Not Applicable

Question 2 of 5

Are you familiar with your organization and state requirements for informed consent?

A

Yes

B

No

C

Not Applicable

Question 3 of 5

Does your signature as a witness verify that the patient is truly informed?

A

Yes

B

No

C

Not Applicable

Question 4 of 5

Would you contact a provider or supervisor if you felt that someone you are working with didn't have a good understanding of risks/benefits/rationale for a recommended treatment/procedure?

A

Yes

B

No

C

Not Applicable

Question 5 of 5

If a patient or client refuses a procedure, do you document that refusal in the client record?

A

Yes

B

No

C

Not Applicable

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