{"text":"Patient Agreement to lnv-estigation or Treatment : - NHS \nN, \n-Greater Glasgow \nand Clyde \nNG A \n10338654X sesssssisesessicssiecscsccsassaes reersrasenen \n. CLELLAND F \nAGNES 08\/09\/1955 \n* 39 RENNIE ROAD S \n, KILSYTH : \nDate of Birth___ \/ \/ : GLASGOW ces 5\u00a5Q vale [] \nCHI-0809555328 \nPatient\u2019s first name(s): \u00ab.ocevvviveiennnnn.. \nNHS\/ CHI Number \n\u2019 \n\u201c\"L-kpecial requirements (e.g. other language\/communication method) \n........................................ \n) propo reatment. \nWhere appropriate specify site or side: (WRITTEN IN FULL) \n| W@m nG'Suomod bwpij \\_L,f\u00abb : \n| have explained the procedure named on this form to the patient in terms which, in my judgement, are \nsuited to their understanding. In particular, | have fully explained: the intended benefits; appropriate \nalternatives which are available (including no treatment); any significant risks which may resuit from \nthe procedure; and any extra procedures which may become necessary during the procedure (please \nspecify major procedures above). - \nAn information leaflet\/tape has been provided. \nSignature of practitioner: \nName\/Designation 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