How to complete a consent form?

1.      Scan the QR code or follow the link below on your phone/iPad/computer;

2.      Fill in the required fields, sign, and take your real-time selfie (not your best photo);

3.      Enter/verify your e-mail (a verification e-mail will be sent to you);

4.      Done. The copy of the signed consent will be e-mailed to you and to the Practice. 

Consent for surgery/operation/procedure(s)

by Dr Oleh Y Matsevych inc (The Practice)

You can tick the specified procedure or/and write in simple language what procedure you are going for.

Use the empty text box in the form to write free text.