Acknowledgment of Informed Consent

I, the undersigned, acknowledge that the services provided by Abid Health Care have been explained to me, including the expected benefits, potential risks, and alternatives. I understand that I have the right to:

I understand and voluntarily consent to the provision of services by Abid Health Care personnel.

Acknowledgment of Understanding of Services

I confirm that the following services have been explained to me:

I have had the opportunity to ask questions and understand the scope, purpose, and limitations of these services.

Advanced Directives

Advanced directives are legal documents that communicate your healthcare preferences in situations where you may not be able to make decisions for yourself. This includes:

• Living Will: Instructions regarding life-sustaining treatment, resuscitation, and end-of-life care.
• Durable Power of Attorney for Healthcare: Designation of a healthcare proxy to make medical decisions on your behalf.

Please indicate your status regarding advanced directives:

Resuscitation Preference (Optional)

Consent for Communication and Confidentiality

I consent to the use of electronic and verbal communication to coordinate my care, including:

I understand that all communication will follow HIPAA and confidentiality guidelines.

Staff Acknowledgment

I have explained the services, risks, alternatives, and the client’s rights, including the option to execute advanced directives. I confirm that the client or representative had the opportunity to ask questions and that informed consent has been obtained voluntarily.