Templates in English and Arabic
Medical consent form templates
Read what you may be asked to sign before care in the UAE, or download a template for your facility to review and adapt.
Template version 1.0, November 2026
What it means
Informed consent means you understand the care, its risks and your options before you agree.
Who takes it
Your treating doctor and facility take your consent, and they stay responsible for your care and its outcome.
Where medicAI fits
medicAI is a technology platform. It is not a healthcare provider and is not a party to these forms.
Your right
You can refuse or withdraw consent at any time, and you do not need to give a reason.
Choose a template.
Open a form to read it in full, or download the PDF to print and sign.
Telehealth consultation consent
الموافقة على الاستشارة الطبية عن بُعد
Before a video or audio consultation with a licensed doctor.
Informed consent for a procedure or treatment
الموافقة المستنيرة على إجراء أو علاج
Before a procedure or treatment that needs written consent. The doctor completes each part for that treatment.
Home lab sample collection consent
الموافقة على سحب العينات المخبرية في المنزل
Before a licensed laboratory collects a blood or other sample at your home.
Wellness and home care service consent
الموافقة على خدمات العافية والرعاية المنزلية
Before IV therapy, a vaccine, a nurse visit or another wellness or home care service from a licensed facility.
Consent by a parent, guardian or next of kin
الموافقة من ولي الأمر أو الوصي أو أقرب الأقارب
When the patient is under 18, or is an adult the treating doctor has assessed as unable to give consent.
Consent to share health information
الموافقة على مشاركة المعلومات الصحية
When you want your records sent to another doctor, facility, insurer or person, for example for a second opinion.
Treatment abroad and data transfer consent
الموافقة على العلاج في الخارج ونقل البيانات
Before your reports are sent to a hospital outside the UAE, or before you travel for treatment.
Photos, videos and advertising consent
الموافقة على الصور والفيديو والإعلانات
Before your pictures, videos or statements are used in advertising or on social media. This is always separate from consent to treatment.
Withdrawal of consent
سحب الموافقة
When you change your mind about a consent you gave for care, or for sharing your information.
Medicine delivery consent
الموافقة على توصيل الأدوية
Before a licensed pharmacy and its delivery partner bring your medicines to your address.
Need a different form?
Each facility writes its own form for each procedure. Ask your facility for theirs, or contact us if you run a facility and need a template we have not listed.
How to use these forms.
How these templates are built
- They follow the two-part layout in the DHA Guidelines for Patient Consent: an information sheet, then a certificate of consent.
- The certificate has statements and signatures from the patient, a witness and the healthcare professional.
- Each form is in Arabic and English, with the details DHA lists, such as full name, age, gender, patient ID, physician, date and time.
If you are a patient
- Take your time. You can ask questions and ask for the form to be read to you or translated.
- Do not sign anything you do not understand, or that has blank parts about your care.
- Keep a copy of what you sign. It becomes part of your health record at the facility.
- Advertising is separate. Your care cannot depend on your photos being used.
If you run a facility
- These are templates only. Your facility is responsible for its consent process, its forms and the care it gives.
- Have your clinical and legal teams review a form and add the details of each procedure before you use it.
- Have the Arabic checked by a qualified legal translator. Patients in other emirates may be covered by the rules of their own health regulator.
Questions people ask
Sources and further reading
- Guidelines for Patient Consent (Dubai Health Authority)
- Standards for Telehealth Services (Dubai Health Authority)
Who should fill in a medical consent form?
The treating doctor or healthcare professional explains the care and completes the details. The patient, or a parent or guardian where needed, reads it and signs. DHA guidelines say the treating professional is responsible for obtaining consent.
Is medicAI a party to these consent forms?
No. medicAI is a technology platform and does not provide healthcare. Consent is between the patient and the treating doctor and facility, who are responsible for the care and its outcome.
Can a clinic use these templates as they are?
They are a starting point. DHA guidelines ask each facility to develop its own consent form for each procedure, in Arabic and English. A facility should have its clinical and legal teams review and adapt a template before using it.
How long does a signed consent last in Dubai?
Under the DHA guidelines, a signed consent form is valid for up to 30 days if the condition of the patient has not changed. It stops being valid if it is withdrawn, or if the condition or the procedure changes.
Does signing a consent form remove the responsibility of the doctor?
No. The DHA Standards for Telehealth Services say consent does not absolve the physician from liability, and the DHA consent guidelines say patients are not held liable for negligence or malpractice.
Can I say no, or change my mind after signing?
Yes. You can refuse or withdraw consent at any time, and you do not need to give a reason. The doctor will explain what stopping means for your health. You can use the withdrawal of consent template to put it in writing.
Who can give consent for a child in the UAE?
DHA guidelines treat anyone under 18 as a minor. Consent is taken from a parent, legal guardian or next of kin, in the order those guidelines and UAE law set out. The facility may ask for proof.
Does a married woman need her husband's consent for medical care in the UAE?
Under the DHA guidelines, a married woman signs her own consent, except for procedures or treatments related to reproductive health. For those, the consent of her husband (first priority) or her legal guardian is mandatory. The informed consent template has a place for this signature. Patients outside Dubai should ask their facility which rules apply.
medicAI is not for emergencies. If someone is seriously ill or injured, call 998 or go to the nearest hospital.
These templates are general information, not legal or medical advice. See our terms of use and legal terms and acceptance for how consent works on medicAI.
