CONSENT FORM FOR HIP & KNEE RECONSTRUCTION TRAINING

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Participant Information:

Name *

Surname *

Date of Birth *

Email *

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Description of the Training:

The cadaveric hands-on training course aims to provide participants with practical experience and knowledge in anatomy, surgical techniques, and medical procedures. Participants will have the opportunity to work with human cadaveric specimens to enhance their understanding and proficiency in their respective field.

Training Procedures:

During the course, participants will engage in various hands-on activities, including but not limited to:
• Dissection and exploration of anatomical structures
• Practice of surgical techniques and procedures
• Examination and identification of anatomical landmarks
• Collaborative learning in small groups
• Demonstration and guidance by experienced instructors

Risks and Benefits:

While every precaution will be taken to ensure participant safety, it is important to note that cadaveric hands-on training involves certain risks, including:
• Exposure to potentially infectious material (although cadavers are screened for infectious diseases)
• Emotional and psychological impact due to the nature of the training
• Allergic reactions to embalming agents or latex gloves (if applicable)
• Musculoskeletal strain or injuries resulting from prolonged or repetitive movements

Benefits of participating in the training include:

• Enhanced understanding of human anatomy
• Improvement of technical skills and proficiency
• Practical application of theoretical knowledge
• Collaboration and networking opportunities with fellow professionals
• Professional development and career advancement

Confidentiality and Data Usage:

Participant information collected during the registration process will be kept strictly confidential and will only be used for the purpose of organizing and evaluating the training program. Any photographs, videos, or other media captured during the training may be used for educational and promotional purposes, but participant identities will be anonymized to protect privacy.

Voluntary Participation and Withdrawal:

Participation in this cadaveric hands-on training is entirely voluntary. Participants have the right to withdraw their consent and discontinue their participation at any time without providing a reason. The decision to withdraw will not impact their current or future medical care or professional standing.

Questions and Concerns:

Participants are encouraged to ask questions, seek clarification, and express any concerns they may have regarding the training. The course instructors and organizers will be available to address these inquiries and provide assistance throughout the program.

Consent:

I understand that during training I will be instructed on and handle myself human specimens that have been cleared for this use by appropriate authorities. Including appropriate infectious disease tests and all necessary precautions have been taking for handling them.

My instructor (s) will explain to me the procedure and the nature, purpose risk and benefits of the operation (s) / procedure(s) and the possibility of complications. My consent is given with understanding that any operation or procedure I will witness, involves risks and hazards and is my responsibility as physician to select the more appropriate for my patients.

I understand that as a trained surgeon is my responsibility to protect myself and my colleagues from injuries by sharp instruments. All sharp instruments must be properly discarded after training in the appropriate sharp spokes.

It is my responsibility to report the staff, any accident, contact with biological material, or injury with any instrument in order to get proper attention.

I consent to the photographing or videotaping all the procedure (s) to be performed – including myself as participant – provided my identity is not revealed without my permission.

I hear by release Regeneration and Progress , their physicians, officers, directors, agents and employees. From any liability in the event of my presence during the procedures result in injury to me, to patient or to others.

I,

Full Name *

have read and understood the information provided in this consent form for Cadaveric hands-on training. I voluntarily agree to participate in the training and acknowledge the risks and benefits associated with it. I understand that I can withdraw from the training at any time without prejudice. By signing below, I give my informed consent for participation.

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