Which of the following is NOT typically included on an informed consent form?

• A. Authorization clause: to permit to perform procedure
• B. Disclosure clause: explanation of procedure, risks and benefits, alternatives procedures
• C. Insurance billing clause
• D. Signature Clause: patient and witness signature

Answer: (C)

Informed consent is about a patient’s voluntary decision after understanding what will be done, why it’s recommended, and the possible risks, benefits, and alternatives. The authorization clause directly reflects giving permission to perform the procedure. The disclosure clause ensures the patient has received complete information about what will happen, the potential risks and benefits, and viable alternatives. The signature clause provides evidence that the patient (and often a witness) have consented to proceed. An insurance billing clause, however, deals with payment and billing for the service, which does not influence the patient’s decision to undergo the procedure. Financial details are handled separately on billing or financial responsibility forms. So, the insurance billing clause is not typically included on an informed consent form.