Get Ampcoil Informed Consent Form La 7.6.18.docx

Filling out the AMPCOIL informed consent form online is a straightforward process that ensures you are well-informed about the use of the AmpCoil system. This guide will provide you with detailed steps to complete this essential document efficiently and accurately.

Follow the steps to fill out the form online.

1. Press the ‘Get Form’ button to obtain the consent form and open it in the designated editor.
2. Enter your full name in the 'Name' field to identify yourself as the applicant.
3. Fill in your address, including the street address, city, state, and ZIP code in the respective fields.
4. Provide your email address and phone number in the designated sections for contact purposes.
5. Indicate how you heard about the AmpCoil service by writing a brief response in the appropriate field.
6. Choose the correct statement regarding your age by selecting either the option for being over 18 or under 18.
7. Confirm that you are not pregnant or nursing by checking the relevant box.
8. Acknowledge that you do not have any electronic implants or devices that may interact with the AmpCoil system by checking the applicable box.
9. Review and agree to the statements regarding metal implants and safety conditions by marking the boxes as appropriate.
10. Read the disclaimer about the AmpCoil system and its intended use carefully, making sure you understand it fully.
11. Sign your name in the designated 'SIGNATURE' field to confirm your acceptance of the terms outlined in the form.
12. Write the date of your signature in the format provided.
13. If required, fill in the name of the individual administering the session in the 'Administered by' field.
14. After completing the form, you can save changes, download, print, or share the form as necessary.

Complete the AMPCOIL informed consent form online to ensure your participation is well-informed and documented.