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 that helps solve the problem of obtaining informed consent from residents in nursing facilities who require treatment with antipsychotic or neuroleptic medications. This form is typically used in situations where a resident's psychiatric condition or maladaptive behavior necessitates medication therapy.

This form requires specific information to be completed by the prescribing physician, their designee, or the nursing facility's medical director. The prescriber must indicate that they have been treating the resident and provide a diagnosis based on diagnostic criteria and assessment findings. The form also outlines the proposed course of therapy, including the medication(s), dosage, and frequency. Additionally, the prescriber must address the risks and benefits of the treatment and indicate the probable clinically significant side effects and risks.

The TX HHS Form 3713 is an essential tool for ensuring that residents in nursing facilities receive informed consent before undergoing antipsychotic or neuroleptic medication treatment. Key features of this form include:

• Required information from the prescribing physician, their designee, or the nursing facility's medical director
• A diagnosis based on diagnostic criteria and assessment findings
• A proposed course of therapy with antipsychotic or neuroleptic medication(s)
• Risks and benefits of the treatment
• Probable clinically significant side effects and risks