or Valve Surgery Consent Form and Patient Information Sheet - health qld gov 2026

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The document is a consent form for patients undergoing Coronary Artery Bypass Graft (CABG) and/or Valve Surgery, detailing the procedures, risks, and patient rights. It includes sections for interpreter needs, medical condition explanation, procedure options, potential risks of surgery and not having the procedure, anaesthetic information, and patient consent acknowledgment. The aim is to ensure patients are informed about their treatment options and the associated risks before proceeding with surgery.

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Click ‘Get Form’ to open it in the editor.
Begin by affixing your identification label at the top of the form. Fill in your family name, given names, address, date of birth, and facility details.
In section A, indicate if an interpreter or cultural support person is required by selecting 'Yes' or 'No'. If applicable, confirm their presence.
Section B requires your doctor to document your condition and the proposed procedure in your own words. Ensure this is clearly noted.
In section C, review the risks associated with the surgery. Make sure you understand these before proceeding.
Complete sections D through H by providing necessary information about risks, consent acknowledgment, and any additional notes as discussed with your doctor.
Finally, sign and date the form in section G to confirm your consent for the procedure.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the ICD 10 code for coronary artery bypass graft surgery?

Informed consent is a process that requires disclosure from the surgeon to facilitate patients understanding, recall and information retention.

Is coronary artery bypass surgery the same as coronary artery bypass graft?

CPT 33533, Under Arterial Grafting for Coronary Artery Bypass. The Current Procedural Terminology (CPT) code 33533 as maintained by American Medical Association, is a medical procedural code under the range - Arterial Grafting for Coronary Artery Bypass.

What is informed consent for cardiac surgery?

Coronary artery bypass surgery creates a new path for blood to flow to your heart. This surgery is sometimes called a coronary artery bypass graft (CABG) or heart bypass. Its the most common heart surgery in adults. You may need this surgery if you have a blocked or partially blocked artery in your heart.

What is the ICD-10 code for coronary artery bypass graft?

Atherosclerosis of coronary artery bypass graft(s) without angina pectoris. I25. 810 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

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