Practice Standard Survey - Consent
A brief survey about the
Practice Standard - Consent
. The
Practice Guideline - Consent
also provides helpful information. All responses are confidential. Individuals will not be identified. Responses will be analyzed based on aggregate data only.
1.
Years of experience as a kinesiologist (optional):
0-5 years
5-10 years
10-15 years
15-20 years
20+ (please specify)
2.
Nature of practice (optional)
Clinical practice
Non-Clinical practice
Mixed Clinical/Non-Clinical
3.
Practice location (see:
Electoral Districts
) (optional)
Northern (Kenora, Rainy River, Thunder Bay, Algoma, Cochrane, Manitoulin, Parry Sound, Nipissing, Timiskaming, Muskoka and Greater Sudbury)
Eastern (Frontenac, Hastings, Lanark, Prince Edward, Renfrew, Lennox and Addington, Leeds and Grenville, Prescott and Russell, Stormont, Dundas, Glengarry and Ottawa)
Central East (Haliburton, Northumberland, Peterborough, Simcoe, Kawartha Lakes, Durham and Scugog
Central (Toronto and York Region)
Central West (Brant, Dufferin, Wellington, Haldimand and Norfolk, Halton, Niagara, Peel, Waterloo, Hamilton and Brantford)
Western (Essex, Bruce, Grey, Lambton, Elgin, Middlesex, Huron, Perth and Oxford, Chatham-Kent, City of London)
Academic (member of a faculty or department of kinesiology at a University in Ontario)
*
4.
Express consent is and may involve (select all that apply)
(Required.)
To acquiesce, agree, approve, assent and give permission to some act or purpose.
Consent that is inferred from signs, actions or facts or by inaction or silence.
Consent that is given directly in explicit words, either verbally or written.
Consent given by a person based upon a clear appreciation and understanding of the facts, implications and future consequences of an action.
*
5.
A patient/client signature on a consent form is required and necessary to document ongoing informed consent.
(Required.)
True
False
*
6.
Please select the highest-ranking Substitute Decision Maker (see pgs. 3-4 of the
Practice Standard
)
(Required.)
A sibling (brother or sister) of the incapable person
The Public Guardian and Trustee
The spouse or partner of the incapable person
The incapable person's attorney for personal care, if the power of attorney confers authority to give or refuse consent to the treatment
The incapable person's guardian, if the guardian has authority to give or refuse consent to the treatment
7.
Please use this space to ask any questions or provide any feedback you may have about the
Practice Standard - Consent
and/or
Practice Guideline - Consent
.