Running a consent session

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This is the chair-side procedure: from the patient sitting down to signed consent documents in their file. It assumes your practice is set up (Getting started). If you would rather understand the mechanism before following it, read How the consent engine works.

Before the patient sits down

Have the patient’s identity details to hand: full name, date of birth, and the CNP or ID document if your paperwork prints them. For a minor or a patient who cannot sign for themselves, you also need the representative’s name, relationship, identity details and the document that empowers them.
If the visit is booked for today, start from the appointment or the patient’s page — either links the session, its documents and the appointment into one visit. A visit is linked only to an appointment that is still scheduled and falls on the clinic’s current day.
If your clinic hands over documents at check-in, do that first. The appointment page reminds you: an amber banner reads “Admission paperwork … has not been signed for this visit.” with a Hand over documents button. See Clinic forms and documents.

Step 1 — start the session and identify the patient

The ways in:

from the appointment — New Recording, which links the session to that appointment (recommended);
from the patient’s page — Start the visit for today’s appointment when the patient is booked today (or Choose today’s appointment: when there are several), otherwise Start the visit;
from the Hub home page — the New consent card, “Capture the informed consent discussion with your patient in one tap.”;
from New consent in the sidebar, where your clinic has the practice documents module;
from a consultation you are writing on the patient’s Consultation tab — Prepare the consent, “For a procedure proposed in this consultation.”, which saves the note first;
from a patient’s signed handover document — Continue the visit.

When the session is linked to an appointment, the wizard says so: “The visit is linked to this appointment: …”.

The wizard’s steps are Patient data, Procedure and Audio consent (Without recording if the patient declines). A psychiatric admission adds an Admission findings step before the audio consent, recorded once per admission.

On Patient data, either Search existing — type a few letters of the name and pick the patient, and their details load — or New patient and type First name, Last name, Date of birth and CNP / ID. If the CNP is already on file, Med says “This CNP is already on file” and offers Use this patient instead of registering them twice; choose It is a different person only after checking the number. An archived patient must be restored to the roster before a visit can start.

If someone else signs for the patient, tick “The patient has a caretaker (someone who cares for them signs the documents)” and fill in the Representative name, Relationship (for example Mother), Representative CNP and Representation document (for example a notarial power of attorney). For a minor, Med labels this Legal representative (minor patient) and requires it: “For a minor, give the representative’s CNP or a representation document.” When the representative signs the audio-recording consent, their CNP is required, because that declaration prints it.

Press Next: Procedure.

Step 2 — choose the procedure and the languages

Pick the procedure through the panels: Type of medicine, then Discipline, then Procedure, each searchable. A clinic that works in a single specialty is not asked for the type of medicine. If the procedure is not in the catalogue, choose Other (type below) and name it — accepting that Med then has no approved wording or pathology annex to draw on for it.

Under Language, Med states the rule: “The signed document is always in Romanian.” Under Translate also into:, choose English, Hungarian or German to also produce informative translations of the documents for this visit — including a signed translated copy of the audio-recording consent for the patient to read.

Below, Med lists the topics to cover in the conversation — the four legal subjects. This is the checklist you are about to be measured against, so it is worth a glance before you start talking. Med’s advice, on the screen: “The more you say out loud, the more complete the documents come out - your words fill the consent first; the standard content only completes what was left unsaid.”

Press Next: Recording.

Step 3 — ask about recording, and get it signed

Read the patient the recording notice on screen. It says the consultation may be recorded solely to assist in preparing medical documentation, that it does not replace the physician’s judgment, that the patient will be asked to sign a declaration describing this in detail, and that they may refuse without any effect on their care.

Then record their answer:

I agree → continue with this step.
Refuse → go to Without a recording below.

If they agree, Med shows the audio recording consent document for review — in Romanian, or in a declared translation language from the Preview language switcher. Choose How will this document be signed? The patient (or the legal representative) then signs it — recording cannot start before this:

On screen (with electronic seal): sign in the signature box, tick “I confirm that the patient (or legal representative) is signing this audio recording consent in person.”, and press Sign consent document. Med confirms “Audio recording consent signed.” and offers View the signed document, so you can hand the patient their copy immediately.
On paper: Med takes you to the hand-signing page — print the document, collect the signature, photograph the signed sheet and upload it — and then returns you to the wizard, which resumes as signed. If this patient already signed an audio-recording consent earlier in the same visit, Med reuses it and does not ask them to sign twice.

Step 4 — record the discussion

Press Start and have the informed-consent conversation. While recording you can Pause and Resume — a pause keeps it as one conversation — and Stop when you are done. Med uploads the audio and takes you to the visit page.

Cover the four subjects out loud. You are not reciting a form: say what the procedure is and what it is for, the risks that matter including the rare serious ones, the real alternatives and what they cost the patient, and what happens if they do nothing. Answer their questions on the recording — the answers you give are extracted and printed on the annex.

Step 5 — read the conversation check

The visit page shows Transcribing the conversation (~1 min)…, then Checking legal topics…, and updates itself. When it is done you get:

the Conversation check panel, with each of the four subjects marked Discussed, Partially or Not discussed, a “N of 4 topics covered” summary, and Coverage details to see the passages behind each verdict;
the transcript, to read before you generate anything;
any signals: a detected refusal, abusive language toward staff, or a warning that speaker attribution was uncertain.

Read the transcript. Transcription is good, not perfect — if a quote matters, check it against the audio. Where the transcription told voices apart, the transcript shows a Who spoke list: each voice with its first words and a suggested role (Patient, Attendant / legal representative, Doctor, Resident doctor, Nurse). Correct any role that is wrong; your correction is marked confirmed, takes precedence over the suggestion, and is what the conversation check reads. If Med hears more voices than expected it says so.

If every subject cleared, continue to step 6.

If something fell short, Med asks How do you want to continue? Choose:

Option	When to use it
Continue recording	The patient is still with you. Record a short follow-up; it joins the same check.
Fill in by hand	You will type the missing detail into the document yourself.
Complete from the clinic’s standard content	Your clinic has approved wording for this pathology and you are content for it to fill the gaps.
Continue without changes	The coverage is genuinely sufficient for this case. Your decision is timestamped on the visit.

I’ll decide later closes the dialog; Change how you continue reopens it. Once you have decided, or once documents start generating, the visit takes no more audio.

Step 6 — generate the documents

Press Generate consent document. Med produces this visit’s set — the informed patient agreement, the pathology annex where one applies, and the self-declaration — and shows “Generating consent documents…” while it works. The page updates itself.

Step 7 — review the fields

Each generated document arrives as a Draft with no printable file yet: the values were filled in from the conversation, and only your confirmation creates the printable document.

Work down the fields:

A field the document needs and nobody supplied is marked required, still empty — fill it in.
Suggest from the clinic library offers passages from your approved content and uploaded protocols for a field, which you can Replace or Add. Where Med proposes library text by itself, it is marked from the clinic library and waits for Keep or Discard. Clearing a field restores the value taken from the conversation.
On the agreement, the block headed Information provided to the patient controls which “Da” boxes print. “Rows found in the conversation are pre-ticked - check them before signing.”
Tables — manoeuvres, people — take extra rows with Add manoeuvre / Add person.

When it is right, press The fields are correct - create the document. Med renders the printable document and tells you which document to review next.

Med walks you through the visit’s documents in order — the panel lists them with ticks as you go, so you can see what is still owed.

Step 8 — sign

For each document, choose How will this document be signed?

On screen (with electronic seal). One signature box appears per signature the document prints — declarant or legal representative, reception or staff, and any clinician or witness lines. Check the identity data shown with the person signing and tick “I have checked the identity data above together with the person signing.”, sign each box, tick “I confirm that every signatory named above is signing this document in person.”, and press Sign document. Med produces the signed PDF in the background and the panel confirms Digitally signed.

Med refuses to apply a signature when the document names the wrong person as signer, when a minor (or an adult recorded as unable to consent) has no legal representative on file, when the copy says the opposite of the visit’s decision to consent or refuse, or when the document changed after it was shown for signing. Each refusal says what to correct.

On paper. In order:

Under Print for wet signature, press Download PDF and print it. Note the Reference ID shown on screen and printed on the sheet.
The patient signs on paper, at the signature lines.
Under Capture signed document, confirm the reference ID, attach one image per page (JPEG, PNG or WebP, up to 15 MB each) or a single multi-page PDF, tick “I confirm this capture shows the wet-signed original for this patient.”, and press Bind capture.

Med refuses a capture that does not match: the page count must be exact, the reference ID must be the document’s own, and a sheet printed from an older version of the document is rejected — “The printed sheet no longer matches this document version. Print the current version again.” On success the document becomes Signed and the scan is the signed document.

Until something has been captured, Change how this is signed takes you back to signing on screen.

After each signature Med tells you where you are — “Document signed (2 of 3). Next up: …” — and takes you to the next one, until “All the visit’s documents are signed.”

Step 9 — finish the consultation

With the visit’s required documents signed, press Finish consultation. Med confirms: “Consultation finished. The conversation and the signed documents remain available on this page.” and points you at the discharge paperwork if your clinic uses it.

If a document is still unsigned, Med refuses — “All consent documents must be signed before finishing the consultation.” — which is the point of the step.

Once the visit owes no more paperwork, Med also moves a scheduled appointment to Completed on its own — see Appointments.

Step 10 — give the patient their documents

From the visit page, Download all documents produces a single archive of everything the visit generated: the signed consents, the audio-recording consent and its signed translations, and any translation annexes. Individual documents download on their own from their own row.

Without a recording

If the patient refuses the recording, Med switches the wizard to Without recording:

Complete the procedure’s intake checklist. These fields are now the document’s main source, so write properly: what the procedure is and its purpose, the risks, the alternatives, and the prognosis without treatment. Med only completes what you leave empty, from your clinic’s approved content.
Press Create intervention.
There is no conversation check to pass — the panel says so. Continue from step 6: generate, review the fields, sign.

Everything else — the documents produced, the review gate, signing on screen or on paper, translations — is identical.

If the patient declines the procedure

This is a documented outcome, not a failure.

If the check heard the refusal, the visit page leads with it and offers Generate the refusal documents. Press it deliberately: it commits the visit to the refusal track and withdraws consent generation. If the patient refuses after signing the consent, use The patient refused after signing and confirm with Mark as refused — “The signed consent stays in the record. The refusal declaration is prefilled from the consultation.”
Med fills the refusal declaration from the visit — diagnosis, procedure, and the consequences of declining — and parks it as a Draft behind the same field-review gate.
Review the fields, confirm, and sign, exactly as for a consent document. Med confirms: “The refusal declaration has been signed. Download it and finish the consultation.”
Then finish the consultation. A refusal visit cannot be finished until its refusal is signed.

If the refusal was a mis-hearing, use Not a refusal? Continue with consent in the banner. To withdraw a refusal once refusal documents exist, first delete the unsigned refusal documents, then Withdraw the refusal. If the patient refuses to sign anything, that is a different document — the refusal minutes, signed by you and two witnesses, filled in by hand. See Clinic forms and documents.

Things that go wrong, and what to do

What you see	What to do
Transcription failed	Press Retry transcription. If it fails again, the audio is safe but unprocessed — contact your clinic administrator.
Analysis failed, or “Automatic verification is unavailable”	Med first retries on its own a limited number of times and says so. If it still fails, press Analyse again. The transcript and audio are unaffected.
“The document is generating - refresh in a moment.” that does not clear	After a couple of minutes a Resume generation button appears; use it.
A document you no longer want, before signing	Delete it from the document’s actions. This also loses the corrections you typed into it; Med generates it again from the conversation.
You need to change the procedure or date	Edit the visit. Regenerating documents afterwards may change what is required.
The patient wants to add something after you finished talking	Use Add follow-up recording on the visit — it is transcribed and folded into the same check. It is available only until you decide how to continue or documents start generating.
“Your active clinic changed”	You have Med open for two clinics. Nothing was saved; reload or switch back to the clinic you started in, then redo the action.