Lawrina’s consent form PDF helps ensure everyone’s on the same page. It’s legally sound, easy to complete, and includes all the key points — so whether you're getting permission from a patient, participant, or parent, you can feel confident your form is complete and compliant.
Consent letter samples are helpful in many situations, especially when someone needs to understand and agree to a procedure, service, or use of their information.
Use a form of consent when:
Start by writing the names and addresses of both the person giving consent and the person or organization receiving it.
From: Sarah Jenkins
Address: 123 Elm Street, Los Angeles, CA 90001
Date: April 15, 2025
To: Bright Health Clinic
Address: 456 Main Ave, Suite 101, Los Angeles, CA 90012
Clearly write what you are saying “yes” to. Be specific so there’s no confusion.
Consent. I, the undersigned, being of legal age, hereby give my informed and voluntary consent for performing the following acts:
Routine blood test and medical evaluation.
Say when the permission starts and ends. You can choose any end date or condition.
Duration. This Consent Form is valid from the date of signing until December 31, 2025.
This part of the blank consent form says how you can cancel your consent if you change your mind later. Just say who to contact and where to send the notice.
Consent withdrawal. I explicitly reserve the right to withdraw my consent at any time without any detrimental consequences for me by notifying Bright Health Clinic in writing at the address specified herein: 456 Main Ave, Suite 101, Los Angeles, CA 90012.
And that’s it! Once you’ve filled everything out, don’t forget to sign and date the basic consent form.