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Need medical care? Let them sign this.

Hospitals and other healthcare institutions and practices should not be places where you get infected. This document makes them aware you are taking precautions to not get infected before your care in the institution. You can fill out/modify this document for your needs and ask them to sign it, thereby making them aware you are prepared to hold the institution accountable should you be infected there.

Original French version by Association Winslow Santé Publique, translated and slightly adjusted with permission for use in the USA:


Deutsche Textvorlagen


Dies ist keine Rechtsberatung. Niemand sollte sich auf diese Textvorlagen verlassen. Nutzer sollten die Vorlagen auf eigenes Risiko verwenden oder ändern, ggf. nach Rücksprache mit Ihrem eigenen Anwalt.

Es ist möglich, dass die Medizinische Einrichtung in Reaktion auf ein solches Schreiben die Behandlung verweigert.

Last reviewed on February 14, 2024

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