Sample Candor Forms
Note: These samples forms are intended to be informational in nature only. Please consult your legal counsel and medical liability insurer prior to implementing a Candor program in your facility.
Sample Patient Notification
is a provider-initiated process. To trigger the protections of the Candor
statute, the provider must provide the patient with a written early disclosure notification.
Sample Patient Consent
statute requires that a patient receive specific notifications. It is important to document that patients participating in a Candor
discussion have received these notifications and acknowledge that they understand their legal rights.
Sample Consent by Others
statute allows either party to invite other individuals, such as family members or legal representatives, to participate in a Candor
discussion. It is important to document that all participants in a Candor
discussion understand the legal protections afforded by the Candor
statute and the confidential nature of these conversations.