Medical Consent Forms

Endoscopy Consent Form: Template and Guidance for Gastroscopy and Colonoscopy

An endoscopy consent form documents a patient's informed agreement before a gastroscopy, colonoscopy, bronchoscopy or similar procedure that uses a camera to examine the inside of the body. Because sedation and instrumentation both carry recognised risks, this form needs more detail than routine care paperwork.

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Written by Mudit AgarwalFounder & Publisher · Digital marketing expert with 8 years' experienceLast updated:

Independently researched and cross-checked against the official primary sources cited on this page. Not written or reviewed by a licensed attorney or clinician. Guidance on this page is sourced from the official publications cited below — it is not a clinical review.

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On this page

This page sets out what an endoscopy consent form should cover, how to describe sedation and biopsy risk clearly, and how consent practice differs across the United States, United Kingdom, Canada, Australia and New Zealand.

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Endoscopy Consent Form — fully formatted and ready to print or edit. No signup, no email required.

What to disclose before an endoscopy

Patients should understand both the intended procedure and the realistic chance that the plan changes once the clinician can see inside the body. This form should record that possibility up front rather than after the fact.

  • The type of endoscopy being performed and why it has been recommended
  • Whether biopsy or polyp removal may occur during the same session
  • The sedation or anaesthesia plan and associated risks
  • Key risks such as bleeding, perforation, infection and reaction to sedation
  • Alternatives, including imaging studies or declining the procedure
  • Post-procedure restrictions, especially around driving after sedation

United States, United Kingdom, Canada and Australia

Consent standards for endoscopy follow each country's general medical consent framework, but sedation-specific disclosure expectations are broadly consistent across tier-1 markets.

United States

State informed-consent law generally requires disclosure of material risks a reasonable patient would want to know, and most endoscopy units use a dedicated consent form covering both the procedure and sedation.

United Kingdom

NHS endoscopy units follow national consent guidance requiring documented discussion of perforation, bleeding and sedation risk, consistent with GMC consent standards.

Canada

Provincial health authorities require documented informed consent before endoscopy, with sedation risk disclosed separately from procedural risk under provincial health consent legislation.

Australia

Australian gastroenterology units follow guidance from professional colleges requiring written consent that names sedation risk, perforation risk and the possibility of biopsy or polypectomy.

When a minor needs an endoscopy

Paediatric endoscopy requires parental or guardian consent in almost all cases, following the same medical consent form for a minor principles used for other paediatric procedures, alongside age-appropriate assent from the child where possible.

After the procedure

The consent conversation should also cover expected recovery time, when results will be available, and who to contact if symptoms such as severe pain or bleeding develop after discharge.

Keep a completed copy in the patient's record alongside the broader set of medical consent forms used across the episode of care.

Frequently asked questions

What risks must be disclosed before a colonoscopy or gastroscopy?

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Material risks typically include bleeding, perforation, infection and reaction to sedation, along with the alternative of imaging or declining the procedure.

Authoritative sources

Official guidance we cross-checked this template against.

Related Consent Forms

Fill out the Endoscopy Consent Form online

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Still required: Patient full name, Date of procedure, Patient signature (or parent/guardian if under 16), Patient signature (or parent/guardian if under 16) — date, Clinician signature, Clinician signature — date.

Patient details
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Patient statement
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