Consent to assessment and treatment at Medical British Academy, I understand that upon signing this document I have received and read Medical British Academy Terms and Conditions provided to me and I agree with the following:
1. I understand that staff at Medical British Academy will take all necessary steps to protect my privacy and information.
2. I understand that Medical British Academy may need to review, use and disclose information about me, my medical/psychiatric diagnosis and treatment to other professionals or care providers. I give permission for Medical British Academy to share information with my GP, the NHS and / or other Specialists, as required.
3. I give permission for my GP to share information with Medical British Academy, both mental health and physical, as required.
4. To the best of my knowledge, my physical and mental health history and status, has been accurately and fully disclosed to Medical British Academy.
5. It is my responsibility to inform Medical British Academy of any changes in my medical status, psychiatric/mental health status and social status. I understand that Medical British Academy will perform a full assessment and may request other investigations, as required. I agree to the treatment plan and will follow the recommended treatment plan, as discussed with Medical British Academy. I am aware that this may carry a risk of side-effects, withdrawal symptoms and possible other complications, if I do not comply with, or adhere to instructions and/or if I exceed the recommended prescribed dosages of medication.
6. I understand that it is at my discretion to stop treatment or investigations, however, if I decide to do so, I understand that this may carry serious risk of side-effects, withdrawal symptoms and/or other complications.
7. I understand that if I decide to stop treatment or the assessment process, I will be solely responsible for any further side-effects or risks due to premature discharge against medical advice.
8. I understand that Medical British Academy are offering an Outpatient Consultation Service only, and are unable to treat patients in crisis, emergency or high-risk situations within, or outside working hours. If my mental health condition deteriorates, and I believe I am in an emergency or crisis situation, e.g., having suicidal thoughts, considering harm to myself, others, or to property, or if I am at risk from others, I will inform my relative/carer and contact your local NHS Crisis Team, go to the nearest A&E, or call an Ambulance or Police on 999 or 111 for immediate support.