Rotunda IVF-COVID-19 – Information and Consent

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Our priority at Rotunda IVF is always to ensure the health and safety of all our patients and staff. As the COVID-19 pandemic is still at large  in our communities we have taking all precautions possible to allow ART treatments to continue in line with national regulations as well as best practice such as ESHRE guidelines. However, vigilance and measured steps must be taken for safe practice and to minimise the risks related to COVID-19.

 

All patients planning to start treatment will need to complete this questionnaire before commencing treatment. A further COVID-19 assessment of both partners may also be performed during ovarian stimulation.

 

All patients with a previous confirmed COVID-19 infection should present medical evidence of clearance in order to be eligible for treatment. If patients have been on respiratory support during the COVID-19 infection episode, they should additionally provide evidence of assessment and a medical specialist report.

 

Note: On arrival at the clinic, patients will be asked to remain outside by the entrance door until they are being called by a staff member.


























Consents
  • I confirm that I have answered the above COVID-19 questionnaire truthfully with the best of my knowledge.

 

 

  • I understand that if there are any evidences that would increase the risk of COVID-19 infection the following precautions may be taken.

 

    • If I belong to the high-risk population or working in a higher risk environment such as Nursing Home or Hospital, extra precaution may be taken such as being ask to wear extra Protective Personal Equipment (PPE) when attending the clinic.

 

    • If I develop any of the COVID-19 symptom(s), treatment may need to be postponed for 14 days after symptoms disappeared or until a COVID-19 test is performed and a negative result is available.

 

 

  • I understand that if I have been diagnosed with COVID-19 infection in the past 4 weeks or otherwise that I will need to present medical evidence of clearance from my GP in order to be eligible for treatment and prior to attending the clinic.

 

 

  • I consent to inform Rotunda IVF immediately (by phone or email) if during treatment I become aware of any new information increasing the risk of COVID-19 infection (i.e. new symptoms, being in close contact with someone who has COVID-19, etc.).

 

 

  • I further understand that if I have been on respiratory support during a COVID-19 infection episode, I will need to provide additional evidence of assessment and a medical specialist report.

 

 

  • I understand that the current evidence would indicate that Covid-19 does not appear to have an impact on fertility treatment risks or success rates.  I also understand that Covid-19 does not currently appear to have an impact on pregnancies or increase the risk of complications. However, the data are extremely limited and I understand that the clinic cannot confirm that Covid-19 will have no impact on the above.

 

  • I understand that Rotunda IVF is taking reasonable measures to reduce the impact of transmission of Covid-19 but that undertaking treatment will affect my ability to maintain social distancing and I accept the risks of this.
  • I understand that I will need to quarantine for 2 weeks if I have travelled to a country not on the green list prior to attending the clinic for treatment.

 

Please confirm that you have read and understood the above consents and wish to proceed with treatment. This is acknowledged as a signed document, confirming that the information contained is true and accurate.