l, the undersigned patient, or legal guardian, or legal guardian, hereby acknowledge that I have been Infomed and understand the following inforrration related to the PRP (Platelet -Rch Plasrrn) treatment offered by Padra Medical Centre LLC
1. Purpose and Description of PRP Treatment:
Platelet-Rich Plasma (PRP) treatment is a medical procedure that involves the extraction and concentration of platelets from a patient's own blood. These concentrated platelets, which contain growth factors and other bioactive substances, are then injected into the patient's affected area to stimulate tissue repair, regeneration, and healing.
2. Expected Benefits:
The potential benefits of PRP treatment may include but are not limited to:
Enhanced tissue healing and regeneration.
Reduction Of pain and inflammation Improved functionality and mobility
3. Risks and Side Effects:
While PRP treatment is generally considered safe, it is essential to be aware of the potential risks and side effects, which may include:
Pain or discomfort at the injection site
Infection, bleeding, or hematoma formation
Allergic reactions or skin irritation
Transmission of bloodborne diseases (highly unlikely, as strict protocols are followed for handling and processing blood)
4. Alternatives:
I understand that alternative treatment options exist, and I have been informed about them. These alternatives may include physical therapy, medication, surgery, or other medical interventions.l have had the opportunity to discuss the risks and benefits of these alternatives with my healthcare provider.
5.Confidentiality:
I understand that my medical records and information related to the PRP treatment will be treated with strict confidentiality, in accordance with applicable privacy laws and regulations. Voluntary Consent:
6.I hereby confirm that I am providing my consent voluntarily and that I have had the opportunity to ask questions and have received satisfactory answers regarding the PRP treatment.
7.Limitations and Success Rates:
I understand that the success of the PRP treatment may vary depending on factors such as the specific conditio being treated, the severity of the condition, and individual patient factors. Although positive outcomes have been reported in many cases, there is no guarantee of the effectiveness of the treatment. Financial Responsibility:
8.I understand that the PRP treatment may involve costs not covered by insurance or healthcare plans. I am responsible for any financial obligations associated with this treatment and have been informed of the estimated costs.
9.Future Use of PRP Information:
I consent to the use of de-identified information related to my PRP treatment for research, educational, or statistical purposes, as long as my identity remains confidential.
10.Right to Withdraw Consent:
I understand that I have the right to withdraw my consent for the PRP treatment at any time before starting the procedure, without affecting my future medical care.
By signing below,
I confirm that I have read, understood, and agreed to the information provided in this consent form. I acknowledge that I have had the opportunity to discuss any questions or concerns with my healthcare provider.
