Which NHS consent form do you need?
The four forms exist because consent works differently depending on who is deciding and whether the patient will be conscious. Picking the right one is the first step in valid NHS consent to treatment.
- NHS consent form 1 — an adult or competent patient consenting to their own procedure, usually involving anaesthesia or sedation
- NHS consent form 2 — a parent or person with parental responsibility consenting for a child or young person
- NHS consent form 3 — procedures where consciousness is not impaired, such as many minor or outpatient procedures
- NHS consent form 4 — adults who lack capacity, where treatment proceeds in their best interests
If none of the four fits, the safer route is a plain-language consent to treatment record rather than editing a numbered form beyond recognition.
What makes an NHS consent form valid
A signature alone proves nothing. UK law and GMC guidance treat consent as the conversation, with the NHS consent form as the evidence that the conversation happened.
- Capacity — the patient can understand, retain, weigh and communicate the specific decision
- Information — benefits, serious or frequently occurring risks, and reasonable alternatives were explained
- Voluntariness — the decision was free from pressure from staff, family or timing
Since Montgomery v Lanarkshire, risk disclosure is judged by what this particular patient would consider significant, not by what a body of doctors would routinely mention.
Who can sign NHS consent to treatment forms
In most cases the patient signs for themselves. Where they cannot, the route depends on age and capacity rather than on who is present at the bedside.
- Adults aged 16 and over with capacity sign their own NHS consent form
- Under-16s may consent themselves if judged Gillick competent for that decision
- Otherwise a person with parental responsibility signs a consent form for a child
- Adults lacking capacity are treated under a best-interests decision recorded on form 4
Relatives cannot consent on behalf of an adult unless they hold a registered health and welfare Lasting Power of Attorney or a court appointment.
How NHS consent forms compare across tier-1 countries
The four-form structure is specific to the UK, but the underlying test of capacity, information and voluntariness is broadly shared across other English-speaking systems.
United Kingdom
NHS England, NHS Scotland, NHS Wales and HSC Northern Ireland use the numbered form set, backed by the Mental Capacity Act 2005 and GMC decision-making guidance.
United States
There is no national form. Hospitals use their own informed-consent paperwork, shaped by state statute and Joint Commission standards — see our general medical consent form.
Canada, Australia and New Zealand
Provincial and state health services publish their own consent forms. Canada follows provincial health-care consent legislation, Australia applies Gillick as adopted in Marion's Case, and New Zealand works to the Code of Health and Disability Services Consumers' Rights.
Filling in an NHS consent form correctly
Most complaints about consent paperwork come from vague procedure descriptions rather than missing signatures. Write the procedure out in full, without abbreviations.
Record the leaflet given, the anaesthesia discussed, and any interpreter used. Where consent is taken well ahead of admission, confirm it again on the day and note that reconfirmation on the form.
- Use the patient's own words for any additional procedures they have refused
- Record the name and grade of the professional taking consent
- File the completed form in the clinical record and give the patient a copy
Storage, copies and withdrawal of consent
The signed NHS consent form belongs in the patient's permanent health record, alongside contemporaneous notes. If the two disagree, the notes usually carry more weight because they describe the discussion in detail.
Consent can be withdrawn at any time before or during treatment while the patient has capacity. Record the withdrawal rather than destroying the form, in the same way you would document a refusal on a surgery consent form.