Please download the appropriate procedure consent form from the list below. If you don't see a consent form specific to your procedure, please use the generic consent form. After the form is completed and signed, please fax it to 206.720.7755.
- Generic:
- Breast Surgery:
- Colon and Rectal Surgery:
- Generic Colon & Rectal Consent Form
- Anal Fistulotomy
- Anal Dysplasia Treatment
- Botox Injection_Drs Gladstone and Wallin
- Condyloma
- Drainage of Abscess
- Examination Under Anesthesia
- Flexible Sigmoidoscopyl
- Hemorroid
- Lateral Internal Sphincterotomy
- Placement of Sacral Neurostimulator Lead and Battery (Step 1 and 2)
- Tags
- Transanal Excision
- ENT:
- Coblation of the Inferior Turbinates
- Functional Endoscopic Sinus (FESS)
- Parathyroidectomy
- Placement of Pressure Equalization Tubes
- Reconstruction of Face, Neck, Scalp, or Nose
- Reduction of the Inferior Turbinates
- Septoplasty
- Stapedectomy
- Thyroidectomy
- Tonsillectomy
- Tonsillectomy with Adenoidectomy
- Tympanoplasty
- Tympanoplasty (Palaskas)
- General Surgery:
- Excision Biopsy of Soft Tissue Mass/Epidermal Inclusion Cyst/Lipoma
- Excision of Skin Masses and Skin Cancer
- Fine Needle Aspiration, Core Biopsy, and Aspiration of Cyst, Seroma, or Abscess
- Hernia Repair, Laparoscopic – Inguinal/Femoral Hernia Repair
- Hernia Repair, Laparoscopic – Umbilical, Ventral, Epigastric, Incisional
- Hernia Repair, Open – Inguinal or Femoral
- Hernia Repair, Open – Umbilical, Ventral, Epigastric or Incisional
- Laparoscopic Appendectomy
- Laparoscopic Gallbladder Removal and Bile Duct X-ray
- Port-a-Cath Insertion
- Port-a-Cath Removal
- Temporal Artery Biopsy
- Wide Excision Melanoma with Sentinel Node
- Gynecology:
- Neurology/Spine Surgery:
- Ophthalmology:
- Orthopedic Surgery:
- Plastic Surgery:
- Podiatry:
- Urology:
- Circumcision (Adult)
- Cystolitholapaxy
- Cystoscopy
- Cystoscopy and Dilation
- Cystoscopy and Stent Placement
- Cystoscopy with or without Bladder Biopsy
- Direct Vision Internal Urethotomy (DVIU)
- Extracorporeal Shock Wave Lithotripsy (ESWL)
- Greenlight Photo Vaporization of the Prostate (PVP)
- Hydrocelectomy or Spermatocelectomy
- Hydrodistention of the Bladder
- Orchiectomy
- Prostate Biopsy
- Prostate Brachytherapy
- Prostate Cryoablation (cryotherapy)
- Transurethral Incision of the Prostate
- Transurethral Resection of the Bladder Tumor (TRBT)
- Transurethral Resection of the Prostate (TURP)
- Transurethral Vaporization of the Prostate (TUVP)
- Ureteroscopy with or without Laser and Stent Placement
- Urethral Sling
- Urology General Procedure
- Vasectomy
- Vascular Surgery: