National radiotherapy consent forms

We are currently improving the design of all forms following feedback from the recent RCR radiotherapy consent form survey. Updated forms will be available here shortly. In the meantime please continue to use the forms below. 

This project is currently being led by RCR Clinical Fellows, Dr Siobhan Morrison and Dr Nish Silva. 

Updates since publication can be viewed in the change log

Contact the Professional Services team if you have any comments, suggestions or questions about the radiotherapy consent forms. 

Anal

Breast

Head and neck

Generic

Lung

Oesophagus

Prostate

Rectal

Skin

Additional information 

There is a unique complexity to the consent process for radiotherapy as there are significant acute risks associated with treatment and late toxicities may present years after treatment. It is therefore generally accepted that the best ethical and legal practice is to ensure valid written, signed consent is sought prior to starting radiotherapy treatment.

  • The taking of written consent should follow a full discussion with the patient of the intended benefits and risks of treatment. 
  • Valid consent is fundamental to respect a patient’s autonomy and is also a legal requirement. 
  • Signing a consent form is not a substitute for a meaningful dialogue and discussion about treatment with the patient. 

Supporting documents 

There are many reasons that a national standard site-specific consent form would assist clinicians and patients alike. Read our supporting documents for further information on the development and implementation of the radiotherapy consent forms:


Change log

We are currently improving the design of all forms following feedback from the recent RCR radiotherapy consent form survey. Updated forms will be published shortly.

In the meatime please continue the forms above.  

FormChange

All

21 May 2021 – misaligned interactive field corrected

22 July 2021 – NHS/hospital number replaced with patient unique identifier to ensure forms are applicable across all devolved nations

22 July 2021 –  Spaces for signatures changed from text field to signature field

Anal

  • Removed from short-term common side-effects – bowel symptoms
    • Passing more mucus or wind compared to what is normal for you
    • Bleeding from the anus or rectum causing blood in the stool
  • Removed from short-term common side-effects – urinary symptoms
    • Pain in the abdomen or back passage
  • Removed from long-term common side-effects – bowel symptoms
    • Daytime/night-time frequency: passing urine more often than normal
    • Urgency: a sudden urge to open your bowels
  • Added to long-term common side-effects – bowel symptoms
    • Mild/moderate incontinence
    • Pain around the anus when opening bowels
    • Mucus discharge or wind from the back passage
    • Bleeding from your bo wel, causing blood in the stool

Head and neck - upper

  • Osteoradionecrosis of the jaw moved from less common early or short-term side-effects to less common late or long-term side-effects