RENEW™ ECP治療同意書

本人認知上述所列的風險和禁忌症並非詳盡無遺,如本人對上述情況有任何疑慮或問題,應在治療前諮詢醫生或相關的專業人士。
I acknowledge that the risks and contraindications listed above are not exhaustive and that I should consult a physician or doctor if I have any concerns or questions about undergoing the Procedure.
(a) 據本人所知,本人沒有上述任何禁忌症;
To the best of my knowledge, I do not suffer from any of the contraindications listed above;

(b) 本人完全了解該治療的相關程序可能涉及的風險;
I am fully aware of the possible risks related to the Procedure;

(c) 本人是自願接受是次治療。
I undergo the Procedure of my own accord.