Final project

Consents Apr 06,2016

ORTHOPAEDIC ========================================================================== *** WORK COPY ONLY *** Printed: Jul 25, 2017 06:34

LOCAL TITLE: CONSENTS DATE OF NOTE: APR 06, 2016@08:45 ENTRY DATE: APR 06, 2016@08:45

AUTHOR: CLERK,NINE EXP COSIGNER: URGENCY: STATUS: COMPLETED

Consent for: anesthesia and right total knee arthroplasty

Consent reviewed by patient: YES Consent signed by patient: YES

Consent reviewed by physician: YES Consent signed by physician: YES Procedure(s) discussed with patient: YES Physician(s) who spoke with patient: surgeon and anesthesiologist

Consent with patient chart: YES

/es/ NINE CLERK FACULTY Signed: 04/06/2016 08:45

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SMITH, JANE 555-55-5502 Jan 01, 1972 (45)