Digital Informed Consent Form (ICF)

Create a digital Informed Consent Form (ICF) template for [PROCEDURE] in the [SPECIALTY] specialty. The form must be legally valid and accessible to patients.

**1) COMPLETE IDENTIFICATION:**
- Patient information (full name, national ID, date of birth)
- Responsible physician: License [NUMBER]/[STATE], Specialty Certification [NUMBER]
- Date, time, and location of digital signature
- Legal guardian (if minor or legally incapacitated)

**2) PROCEDURE INFORMATION:**
- Plain-language description of what will be performed
- Medical indication based on the clinical case
- Technique used and available alternatives
- Anesthesia type: [ANESTHESIA_TYPE]
- Estimated duration and facility where it will be performed
- Hospital admission required: [YES/NO — DURATION]

**3) RISKS AND COMPLICATIONS:**
- General risks (infection, bleeding, anesthesia reaction, thrombosis)
- Procedure-specific risks of [PROCEDURE] with available percentages
- Rare but serious complications
- Procedure limitations

**4) EXPECTED OUTCOMES:**
- Realistic expectations (no outcome guarantees — prohibited by CFM)
- Recovery time and post-procedure restrictions
- Possibility of revisions or additional procedures
- Factors influencing outcomes (smoking, weight, genetics)

**5) PATIENT DECLARATIONS AND AUTHORIZATIONS:**
- Checklist: allergies, medications, prior conditions, pregnancy
- Statement confirming understanding of all information provided
- Authorization for photographic documentation (separate form)
- Acknowledgment of possible additional costs
- Statement confirming opportunity to ask questions

**6) DIGITAL SIGNATURE:**
- Legally valid format in Brazil (ICP-Brazil or equivalent)
- Witnesses when required
- Digital copy sent to patient

Legal basis: Code of Medical Ethics (CFM Resolution 2,217/2018), Civil Code Article 15, Consumer Protection Code Articles 6 and 39. Reading level: 8th grade.