Article | April 2015
Commonly Used Patient Forms in Spanish
Consent, Refusal, Instruction and Treatment forms for Spanish-speaking patients
When your patient's primary language is Spanish, it impedes your ability to get accurate information with English forms. Use these Spanish forms from Cigna HealthcareSM for better communication, and better care.
Consent Forms
- Consent to Immunization - Adult
- GI Consent to Operation or Other Medical Services
- Consent to Photograph
- Consent for Depo-Provera
- Important Information about Influenza and Influenza Vaccine
- Consent to Medical Treatment of a Minor
- Outpatient Surgery Consent to Operation or Other Medical Services
- Informed Consent for Psychotropic Medication Treatment
Refusal of Treatment or Services Forms
- Refusal of Medical Services Against Medical Advice
- Refusal to Vaccinate
Treatment Instructions and Other Clinical Forms
- Blood Pressure Pocket Card
- Endoscopy Outpatient Discharge Instructions
- Home Instructions - Medical
- Pediatric Sports Physical History
- Pre-Stimulant Cardiac Screening Checklist
- Home Instructions - Trauma
More Resources for ESL Patients
More Resources on Health Equity
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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see
All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.