{"id":6229,"date":"2023-03-21T14:26:10","date_gmt":"2023-03-21T14:26:10","guid":{"rendered":"https:\/\/www.mediclinic.it\/modulistica\/"},"modified":"2025-10-02T09:19:04","modified_gmt":"2025-10-02T09:19:04","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.mediclinic.it\/en\/forms\/","title":{"rendered":"Modulistica"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-bottom:111px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_4_5 4_5 fusion-flex-column\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-width-large:80%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.4%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.4%;--awb-width-medium:80%;--awb-spacing-right-medium:2.4%;--awb-spacing-left-medium:2.4%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\"><h2 class=\"fusion-title-heading title-heading-center\" style=\"font-family:var(--awb-typography2-font-family);font-weight:var(--awb-typography2-font-weight);font-style:var(--awb-typography2-font-style);margin:0;\">Forms<\/h2><\/div><div class=\"fusion-text fusion-text-1\"><h3>Personal data confidentiality<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2023\/10\/FRO_Doc_11_UK_Informativa-e-tutela-riservatezza-dati-personali-REV.11.pdf\">Privacy notice and data protection form<\/a><\/li>\n<\/ul>\n<h3>Medical Reports<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2025\/10\/FRO_Doc_05_UK_Delega-ritiro-referti-Rev.1.pdf\">Authorization for Collection of Medical Reports<\/a><\/li>\n<\/ul>\n<h3>Imaging<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2025\/07\/RAD_Doc_02_UK_consenso-mammo-REV.4.pdf\">Informed consent form for 2D\/3D mammography<\/a><\/li>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2023\/10\/RAD_Doc_09_UK_consenso_RX_Rev.-2.pdf\">Informed consent form for conventional radiology<\/a><\/li>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2024\/03\/RAD_Doc_12_UK_modulo-MDC_TC_RM_Rev.-5.pdf\">Consent form for iodinated or paramagnetic contrast medium administration<\/a><\/li>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2023\/10\/RAD_Doc_07_UK_anamnesi_consenso_RM_ARTRORM_Rev.-3.pdf\">Medical history questionnaire and informed consent form for MRI and arthrogram MRI<\/a><\/li>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2023\/10\/RAD_Doc_08_UK_consenso_TC_ARTROTC_Rev.-2.pdf\">Informed consent form for Computerized Tomography (CT scan and arthrogram CT)<\/a><\/li>\n<\/ul>\n<h3>Medical records<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2023\/10\/FRO_Doc_10_UK_richiesta-copia-cartella-certificato-di-ricovero-PRIME_Rev.7.pdf\"><span data-sheets-value=\"{\" data-sheets-userformat=\"{\">Medical records \/ certificate of inpatient admission<\/span><\/a><\/li>\n<\/ul>\n<h3>Rehabilitation<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2024\/11\/FKT_Doc_09_UK_informativa_laserterapia-alta-potenza.pdf\">High-intensity laser therapy<\/a><\/li>\n<li><a href=\"https:\/\/www.mediclinic.it\/mcn\/wp-content\/uploads\/2024\/11\/FKT_Doc_07_UK_informativa-e-consenso-Onde-durto.pdf\">Focused shock wave therapy<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"_acf_changed":false,"_joinchat":[],"footnotes":""},"class_list":["post-6229","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.1 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Modulistica - MediClinic<\/title>\n<meta name=\"description\" content=\"Modulistica di MediClinic - Casa di Cura. 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