Medical Refusal Of Treatment Form - Remember to complete an incident report form as soon as possible. Individuals are legally entitled to exercise their freedom of choice by choosing not to undergo a recommended course of treatment, medication, or testing. Use this form if an employee has a minor injury and they do not feel that they need medical treatment. If the employee’s injury is obvious, get medical attention and/or call 911, if necessary. Web the employee refusal of medical treatment form template is designed to collect acknowledgment and consent from employees who refuse to be medically treated. Web refusal to consent to treatment, medication, or testing. Having considered all of my options and understanding the risks of declining the treatment, medication, or testing, i have decided not. I have had an opportunity to discuss and ask questions concerning the recommendations and alternative treatment recommendations. _____ i am provided with this refusal form and information so i may understand the recommended treatment and the consequences of refusing treatment.
_____ i am provided with this refusal form and information so i may understand the recommended treatment and the consequences of refusing treatment. If the employee’s injury is obvious, get medical attention and/or call 911, if necessary. Web refusal to consent to treatment, medication, or testing. Individuals are legally entitled to exercise their freedom of choice by choosing not to undergo a recommended course of treatment, medication, or testing. Use this form if an employee has a minor injury and they do not feel that they need medical treatment. Web the employee refusal of medical treatment form template is designed to collect acknowledgment and consent from employees who refuse to be medically treated. I have had an opportunity to discuss and ask questions concerning the recommendations and alternative treatment recommendations. Remember to complete an incident report form as soon as possible. Having considered all of my options and understanding the risks of declining the treatment, medication, or testing, i have decided not.