EXTRA-CORPOREAL SHOCKWAVE THERAPY CONSENT FORM 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name in the designated field. This identifies you as the patient receiving treatment.
  3. Next, provide your signature in the appropriate section. This confirms your consent to undergo extracorporeal shockwave therapy.
  4. Finally, date the form by entering today’s date. This is crucial for record-keeping and verifying when consent was given.

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Informed consent is still a requirement for the use of ECT both in voluntary and compulsory treatment; however, since severe mental illness can affect decision-making capacity and insight of the need for treatment, this requirement often constitutes an obstacle to its use.
Radial Shock Wave Therapy (Package) - 99 For 1 Session Single sessions cost Radial Shock wave Therapy at 99, an average of 3-4 sessions. The technology differs from the Focused Therapy type, which is reflected in the cost.
Only a qualified physician (certified by National or International Societies) may use focused shockwave therapy to treat pathologies, which have been determined by diagnostic testing.
Generally, the technique is inadvisable for people who are pregnant or have a severe infection, a serious blood clot disorder, certain injuries, or certain structures in the treatment area. It may also be unsuitable for those with certain cancers. Low energy doses may sometimes be more suitable over high energy ESWT.
There are no insurances (except for some Workers Compensation cases) that cover the treatment although the treatment is FDA compliant and there is a plethora of scientific data supporting the use of Shockwave.