SECTION 604.5. Disclosure and Consent Form for Anesthesia and/or Perioperative Pain Management (Analgesia)


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  • The Texas Medical Disclosure Panel adopts the following form which shall be used to provide informed consent to a patient or person authorized to consent for the patient of the possible risks and hazards involved in anesthesia and/or perioperative pain management (analgesia). Providers shall have the form available in both English and Spanish language versions. Both versions are available from the Health and Human Services Commission.

    (1) English form.

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    (2) Spanish form.

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Source Note: The provisions of this §604.5 adopted to be effective December 26, 2023, 48 TexReg 7997