Informed consent for diagnostic or interventional cardiac catheterization, including coronary angiography and percutaneous coronary intervention (PCI). Single signer (patient).
The Cardiac Catheterization Informed Consent is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 1 signer (patient) and, by default, expires 30 days after it is sent if left unsigned. It covers consent, cardiology, cardiac catheterization, pci, angiography, healthcare. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.
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# Cardiac Catheterization Informed Consent > **Important — not medical advice.** For use by a licensed provider; tailor to the patient, your protocols, and state law. **Date:** ___________ **Facility Name:** ___________ **Performing Physician:** ___________ **Patient Name:** ___________ **Date of Birth:** ___________ **Medical Record Number:** ___________ --- ## 1. Description of the Procedure Cardiac catheterization is an invasive diagnostic and/or interventional procedure in which a thin, flexible tube (catheter) is inserted into a blood vessel — typically the radial artery in the wrist or the femoral artery in the groin — and guided to the heart and coronary arteries under X-ray fluoroscopy. **Planned procedure:** ___________ **Access site:** ___________ **Contrast agent will be used.** I have been asked about allergy to iodinated contrast or seafood, and I have disclosed any known allergy to my physician. **Known contrast allergy on file:** ___________ --- ## 2. Indication / Medical Reason This procedure is recommended because: ___________ --- ## 3. Expected Benefits