TX HHS Form 3713. Nursing Facility Consent for Antipsychotic or Neuroleptic Medication Treatment

The TX HHS Form 3713, "Nursing Facility Consent for Antipsychotic or Neuroleptic Medication Treatment", is a crucial document used to obtain consent from nursing facility residents for the treatment of psychiatric conditions using antipsychotic or neuroleptic medications. This form helps solve the problem of ensuring that residents are properly informed and consenting to their medication treatment, while also providing healthcare professionals with a standardized framework for documenting patient information.

The form requires completion by the prescribing physician or designee, including the resident's name, social security number, and prescriber's information. The prescriber must also indicate that they have been treating the resident since [date] and provide a diagnosis based on specific diagnostic criteria and assessment findings. Additionally, the form outlines the proposed course of therapy, including the medication(s), dosage, and frequency.

This form should be used when a nursing facility resident requires treatment for a psychiatric condition using antipsychotic or neuroleptic medications. The form's importance lies in its requirement to address all questions related to the proposed treatment, including risks and benefits, as well as probable clinically significant side effects and risks. By completing this form, healthcare professionals can ensure that they are obtaining informed consent from residents while also documenting essential patient information.