Minor Surgery Consent Form



TO BE COMPLETED BY THE PATIENT/PARENT OR GUARDIAN

I agree for the proposed operation/procedure to be carried out under local/topical anaesthesia.

I understand the nature, purpose and complications (including possible scarring and pigmentary changes) of which have been explained to me.



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TO BE COMPLETED BY THE DOCTOR PERFORMING THE PROCEDURE

I confirm that I have explained the nature, purpose and complications (including possible scarring and pigmentary changes) of the procedure.


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