FIRAZA UROLOGY Consent Form for Telemedicine Consultation

Instructions to FIRAZA UROLOGY patients:

Found below are two translations of our consent forms. Please download them on the links according to your preferred language:

ENGLISH VERSION: https://bit.ly/2LISfN7

FILIPINO VERSION: https://bit.ly/2zbItk4

For patients with Printers:

Print the consent and fill up your personal details and sign in the designated areas. Please do not forget to put the date and time of your signing of the consent forms. Please Email to cdo.urologist@gmail.com the SCAN COMPLETELY FILLED-UP & SIGNED copy or CLEAR PHOTO of the COMPLETELY FILLED-UP SIGNED copy.

For patients without Printers:

Please download and install the ADOBE FILL and SIGN APPLICATION on your mobile phones. There two download links below according to your phone: Please Email to cdo.urologist@gmail.com the COMPLETELY FILLED-UP & SIGNED PDF copy or CLEAR PHOTO of the COMPLETELY FILLED-UP SIGNED PDF copy.

ADOBE FILL & SIGN for ANDROID Phones at Google Playstore ---> https://bit.ly/2ZjmzpR

ADOBE FILL & SIGN for IPHONEs at App Store ---> https://apple.co/3bLIdpc