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Patients authorize their physician to perform Mohs micrographic surgery and any necessary surgical repairs, understanding that additional unanticipated procedures may be required.
Patients must acknowledge their diagnosis, which commonly includes basal cell carcinoma or squamous cell carcinoma.
Patients are informed about the risks associated with the procedure, including bleeding, infection, scarring, and potential recurrence of cancer.
The form outlines alternative treatment options such as standard excisional surgery, radiotherapy, and other modalities.
Patients consent to the administration of anesthesia or sedation, acknowledging the associated risks including allergic reactions and changes in vital signs.
Patients understand that representatives from medical equipment manufacturers may be present during procedures for consultation or checks.
Patients consent to photographs or recordings during the procedure for educational or performance improvement purposes.