Consent Form For Injections and Treatment with Plasma Rich in Platelets (PRP)

I understand and accept that if I undergo injection and treatment with Platelet-Rich Plasma (PRP) under the supervision and recommendation of my attending physician, I have the opportunity to discuss and clarify all my doubts related to the procedure and the possible risks involved. Next, I give my informed consent.

1.   Purpose of treatment:

Treatment with Platelet-Rich Plasma (PRP) aims to promote the healing and regeneration of the affected tissues by injecting my own plasma enriched with platelets.

2.   Procedure:

o   The doctor will take a sample of my blood.

o   The blood sample will be processed by a special centrifugation to separate and concentrate the platelets.

o   The resulting Platelet-Rich Plasma (PRP) will be injected into the affected area, as determined by the attending physician.

3.   Risks and Possible Side Effects:

PRP is my blood, which minimizes the risk of allergic reactions or infection. However, as in any medical procedure, there may be risks and side effects, such as:

o   Temporary pain or discomfort at the injection site

o   Bruises, redness or inflammation in the treated areas

o   Infection at the injection site, although it is rare due to the use of my own blood.

o   Sensitivity or other changes in the skin in the treated area

4.   Expected benefits:

Treatment with PRP can provide pain relief and promote the healing of injuries or conditions in the treated area. The results may vary depending on the severity if my condition and individual healing system.

5.   Alternatives and consent for its use:

I have been informed about other treatment options available and their possible benefits and risks. I understand that I have the right to request additional information before deciding if the treatment with PRP is appropriate for me.

6.   Complications and unforeseen results:

It is important to recognize that specific results cannot be guaranteed, and that complications or unexpected results can arise in any medical procedure.

7.   Consent and release from liability:

I have read and understood the information provided about the treatment with Platelet-Rich Plasma (PRP). I understand that my consent is voluntary and that I have the right to withdraw it at any time. I agree to assume the potential risks and release the doctor and clinic staff from any responsibility related to PRP treatment.