{"text":"MULTIDISCIPLINARY NOTES \nDATE \/ TIME \nDISCHARGE YES NO \n1. STABLE VITAL SIGNS e \n2. CANNULAE REMOVED ' L] \n3. ABLE TO DRESS, SIT AND WALK UNAIDED s [ ] \n4. TOLERATING FOOD AND FLUIDS [} [] \n5. INSTRUCTIONS GIVEN SEDATION 94\u2014 [ \n6. GPLETTER'GIVEN BEFORE DISCHARGE +4\u2014 \n7. FOLLOW UP APPOINTMENT P \nDISCHARGE AT \u2018 ' TO__ _CARE \nNURSE\u2019S SIGNATURE \nCONSENT FORM | ' \n.................... :..............:.........................g Specia[ requirements (e.g. other |anguage \/ \nLRI EEE R Communication MENOA) \u00ab.vvereteeeeetietieteeceeerere e \ncLmiam. r \nAGNES 08\/09\/1955 : Proposed operation, investigation or other treatment. \n. 39 RENNIE ROAD : . \nGLASGOW G65 9PQ \nCHI-0809555328 \nKILSYTH \u2018 : (BLOCK CAPITALS) \n.............................................................. \n| have explained the procedure named on this form to the patient in the terms which, in my \njudgemient, are suited to their understanding. In particular, | \u201chave fully explained: the intended \nbenefits; appropriate alternatives which are available (including no treatment); any sign if cant risks \nwhich may resuit from the procedure; and any extra procedures which may become necessary during \nthe procedure (please specify major procedure above). \nAn information leaflet\/tape has been Provided .......coeceueceuiereererreeeieee e eeee s nesssenan, e \nSignature of Practitioner ... WS @ \nName.\/ Designation (Print) *Dl@UAr S TR QE-\u201cC\"\"%W(J i \nDate.' ...... [0(\/ ...... Lo\/ O\ufb01 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