PATIENT INFORMED CONSENT

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Phlebotomy Procedure Overview:

Phlebotomy involves the collection of blood from a vein, usually in the arm, for laboratory testing, diagnosis, or treatment monitoring. The procedure is commonly performed by a phlebotomist, nurse, or healthcare professional.

Purpose:

The purpose of this procedure is to obtain a blood sample for the following reason(s):

*Diagnostic Testing: To diagnose a health condition based on blood analysis.
*Monitoring: To monitor an existing health condition or the effectiveness of treatment.
*Screening: To screen for potential health issues as part of a routine check-up.

Procedure Description:

Preparation:

The site of the blood draw will be cleaned with an antiseptic wipe.
A tourniquet will be applied to your upper arm to make the veins more visible and easier to access.

Blood Draw:

A sterile needle will be inserted into a vein, and blood will be collected into one or more tubes.
Once the required amount of blood is collected, the needle will be removed, and pressure will be applied to the puncture site to stop any bleeding.

Post-Procedure:

A bandage or plaster will be applied to the puncture site.
You may be asked to remain seated for a few minutes to ensure you feel well before leaving.

Potential Risks and Discomforts:

Mild discomfort or pain at the puncture site.
Bruising or swelling at the puncture site.
Feeling lightheaded or faint.
Rarely, infection or excessive bleeding.

Benefits:

Accurate diagnosis and monitoring of health conditions.
Information that assists in planning appropriate treatment.

Patient Responsibilities:

Inform the healthcare provider of any allergies, medical conditions, or medications you are taking.
Follow any pre-test instructions provided by your healthcare provider.
Report any unusual symptoms or reactions following the procedure.

Confidentiality:

Your test results and medical information will be kept confidential in accordance with UK health guidelines and data protection laws. Results will only be shared with healthcare professionals involved in your care.

Patient Consent:

I have read and understood the information provided above. I have had the opportunity to ask questions and have received satisfactory answers. I understand the purpose, procedure, potential risks, and benefits of phlebotomy. I consent to the blood draw procedure.

The procedures and risks have been explained to me. I have been given the opportunity to ask questions about the procedure and about the risks, hazards, and possible complications involved. I have discussed and understood alternative methods of phlebotomy with my physician or phlebotomist.

I understand that there are no guarantees concerning the outcome of this procedure. All my questions have been answered to my satisfaction.

In the event of a reaction or complication, the treating Medical Staff will provide immediate emergency medical care as indicated.

I have been informed that all information obtained in connection with this procedure, including all test results and review of my medical history and records will remain confidential to the extent provided by UK regulation, and local law.

I understand that the decision to participate is voluntary. I understand that I am free to withdraw my consent, via email.

I hereby authorize that the blood cells removed from me be discarded appropriately.

Do you consent *

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Certain tests needs 8-10 hrs of fasting, please confirm with our staff *

Are you fasting?

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Are you taking any medication or supplements? *

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Did you have any surgery in the past? *

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Do you have any medical condition? *

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