Cardiopulmonary Exercise Stress Test Consent Form and Patient Information Sheet Queensland Health. Cardiopulmonary Exercise Stress Test Consent Form and Patient Information Sheet 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your personal details such as Family Name, Given Name(s), Address, Date of Birth, and Facility. Ensure accuracy for proper identification.
  3. Address any interpreter or cultural needs by selecting 'Yes' or 'No' for the required services. If applicable, indicate if a qualified interpreter or cultural support person is present.
  4. In section B, review the doctor's explanation of your condition and treatment. Ensure that this is documented in your own words for clarity.
  5. Read through the risks associated with the cardiopulmonary exercise stress test outlined in section C. Acknowledge your understanding of these risks.
  6. Provide consent in section F by signing and dating the form after discussing all points with your doctor. If applicable, include information about a substitute decision maker.
  7. Finally, ensure that all sections are completed before submitting the form through our platform for processing.

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Individuals should sign an informed consent form prior to exercise testing. The purpose of the consent form is to make certain the patient is aware of the small, but real risk of exercise testing.
Do not eat or drink caffeinated products (chocolate, soda, tea, coffee or Excedrin) for 24 hours before exam. Note: Decaffeinated products contain caffeine and should be avoided as well. Do not eat or drink for three hours before your appointment. Drinking water is okay.
Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place for example, holding out an arm for a blood test. Consent should be given to the healthcare professional responsible for the persons treatment. This could be a: nurse arranging a blood test.
Test Details Not eat anything in the hours leading up to the test. Avoid caffeine for 24 hours before testing. Not smoke or use tobacco products. Stop taking certain prescription medications the day of your test. Try to relax. Wear lightweight, comfortable clothes and sturdy walking shoes.
Nonphysician health professionals may administer and even supervise exercise testing independently, but physician involvement is essential with respect to delineation of testing policies/standards, medical safety standards and monitoring, physical proximity in emergent situations, and direct participation for patients

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