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1. Patient Information: Details of the minor patient including full name, date of birth, ID number, and contact information
2. Capacity Declaration: Statement confirming the minor's age is above 12 and assessment of their capacity to understand and consent to treatment
3. Emergency Contact Information: Alternative contact persons and their relationship to the minor
4. Medical Treatment Details: Description of the medical treatment, procedure, or examination being consented to
5. Risks and Benefits: Clear explanation of the potential risks and benefits of the treatment
6. Healthcare Provider Declaration: Statement by the healthcare provider confirming explanation of treatment and assessment of minor's capacity to consent
7. Minor's Consent Declaration: Explicit statement of consent by the minor and confirmation of understanding
8. Signatures and Witnesses: Space for minor's signature, healthcare provider's signature, and witness signatures with dates
1. Interpreter Declaration: Required when explanations are provided in a language other than the minor's primary language
2. Special Medical Conditions: Section for documenting any existing medical conditions, allergies, or medications that may affect treatment
3. Parent/Guardian Notification: Optional section for cases where parents/guardians will be notified after treatment, though consent is not required
4. HIV Testing Consent: Specific section required when HIV testing is part of the treatment or procedure
5. Mental Health Treatment: Additional provisions required for mental health services under the Mental Health Care Act
6. Photography Consent: Optional consent for medical photography if required for treatment documentation
1. Schedule A: Medical Procedure Description: Detailed technical description of the medical procedure or treatment
2. Schedule B: Patient Rights: Summary of patient rights under South African law, including the right to refuse treatment
3. Appendix 1: Proof of Age: Copy of ID document or birth certificate confirming minor's age
4. Appendix 2: Capacity Assessment Form: Standardized form used by healthcare provider to assess minor's capacity to consent
Healthcare
Medical Services
Pediatric Care
Emergency Medicine
Mental Health Services
Public Health
Hospital Administration
Medical Insurance
Legal Services
Social Services
Legal
Medical Administration
Clinical Operations
Compliance
Risk Management
Patient Services
Quality Assurance
Medical Records
Emergency Services
Pediatrics
Medical Doctor
Pediatrician
Emergency Room Physician
Nurse Practitioner
Hospital Administrator
Healthcare Facility Manager
Legal Counsel
Compliance Officer
Medical Records Manager
Social Worker
Clinical Psychologist
Healthcare Risk Manager
Patient Services Coordinator
Medical Secretary
Admissions Officer
Quality Assurance Manager
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