Consent for Medical Care

Hidalgo Integrative Medicine, PLLC

Consent for medical care

You must be informed about your condition and the recommended medical, surgical, or diagnostic procedure to be used so that you can make a decision whether or not to undergo any suggested treatment or procedure after knowing the risks and hazards involved. Until you are evaluated, no specific treatment can be recommended. However, I must obtain your permission to perform an evaluation that is necessary to identify your condition, and to perform any necessary treatments and or procedures.

This consent provides me permission, from you, to perform reasonable and necessary medical examinations, testing, and treatment. By signing below, you are indicating that you intend that this consent is continuing in nature even after a specific diagnosis has been made and treatment recommended. The consent will remain fully effective until it is revoked by you, the patient, in writing. You have the right at any time to discontinue services.

I encourage you to discuss any questions with me and or your personal physician about any procedure or diagnosis, potential risks, and benefits of any test or procedure performed here at Hidalgo Integrative Medicine, PLLC.

I voluntarily allow Dr. Hidalgo to perform reasonable and necessary medical examinations, testing and treatment for the condition which has brought me to seek care at this practice. I understand that if additional testing, invasive or interventional procedures are recommended, I will be asked to read and sign additional consent forms prior to the test(s).

I also understand that Dr. Hidalgo will not be my primary care physician while working under the premise of Hidalgo Integrative Medicine, PLLC and that I must obtain routine acute and chronic medical care elsewhere.

I acknowledge, certify and fully understand the above statements and consent by signing below.