Texas Administrative Code

Texas Administrative Code

TITLE 25	HEALTH SERVICES
PART 7	TEXAS MEDICAL DISCLOSURE PANEL
CHAPTER 601	INFORMED CONSENT
RULE §601.4	Disclosure and Consent Form

(a) The Texas Medical Disclosure Panel adopts the following form which shall be used by a physician or health care provider to inform a patient or person authorized to consent for the patient of the possible risks and hazards involved in the medical treatments and surgical procedures named in the form. Except for the procedures shown in subsection (b) of this section, the following form shall be used for the medical treatments and surgical procedures described in §601.2 of this title (relating to Procedures Requiring Full Disclosure of Specific Risks and Hazards--List A). Providers shall have the form available in both English and Spanish language versions. Both versions are available from the Health and Human Services Commission.

(1) English form.

Attached Graphic

(2) Spanish form.

Attached Graphic

(b) Informed consent for:

(1) radiation therapy shall be provided in accordance with §601.5 of this title (relating to Disclosure and Consent Form for Radiation Therapy);

(2) electroconvulsive therapy shall be provided in accordance with §601.7 of this title (relating to Informed Consent for Electroconvulsive Therapy);

(3) hysterectomy procedures shall be provided in accordance with §601.8 of this title (relating to Disclosure and Consent Form for Hysterectomy); and

(4) anesthesia and/or perioperative pain management (analgesia) procedures shall be in accordance with §601.9 of this title (relating to Disclosure and Consent Form for Anesthesia and/or Perioperative Pain Management (Analgesia)).

Source Note: The provisions of this §601.4 adopted to be effective October 3, 1995, 20 TexReg 7486; amended to be effective February 18, 1998, 23 TexReg 1307; amended to be effective November 28, 2004, 29 TexReg 10780; amended to be effective October 16, 2005, 30 TexReg 6435; amended to be effective January 16, 2012, 36 TexReg 8557; amended to be effective January 7, 2016, 40 TexReg 7073; amended to be effective January 1, 2020, 44 TexReg 3129