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Home Providers Provider ResourcesCommonly Used Patient Forms in Spanish

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 for better communication, and better care.

Download the packet [PDF] and get access to all these forms and instructions:

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

Tips for Working with a Language Interpreter Interpretation and Translation Services

More Resources on Health Equity

LGBT Health Disparities Podcast: Diabetes in South Asians Promoting Colon Cancer Screening in the African-American Community Explore all resources on Cultural Competency and Health Equity

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