ARD Patient Advocacy

Please note that all information provided on this web site, or in response to any communication with the International Adhesions Society, or Synechion, Inc., is not intended nor is implied to constitute professional medical advice nor does it substitute for professional medical advice. Always seek the advice of your physician or other qualified health care provider prior to starting any new treatment or regarding a medical condition or its current treatment. State laws prohibit the practice of telemedicine with licensure in each state.

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Adhesions & Bowel Obstruction........Take the newest IAS Survey..........

IAS RESEARCH PROJECT

"Informed Consent and Adhesions"

Have you heard of it? Do you know what it is?

The IAS wants to learn about your experience with Informed Consent forms

THIS INFORMATION WILL BE VITAL TO OUR CAMPAIGN OF AWARENESS AND ACTION

Help the IAS learn more about the information being provided on the hospital (or physician’s office) informed consent forms that patients are asked to complete each time there is a surgical procedure performed. This information will help us understand how we can improve awareness about adhesions among doctors and patients. We need to see as many examples of informed consent as possible regardless of whether they mention adhesions or not.

WE ARE ONLY INTERESTED IN ABDOMINAL OR PELVIC SURGERY at this time.

How You Can Help?

Participate in our Informed Consent Survey

By taking a moment to answer the questions below, you can provide us with information that will assist us in our continued efforts to create awareness and take action for Adhesions and ARD.

Here's how:

Answer the survey via the one on this page or the one that may have appeared as a pop-up when this page was displayed on your computer screen.
After you press submit, you will be asked for your email address. Please enter this information and click "submit vote". A message will appear to indicate you have an email.
Go to your email box and open the message that says "your confirmation required".
Click the link at the bottom of this email to register your vote! VERY IMPORTANT. This must be done in order for your information to be added to the results and be calculated!
After clicking the link in your email, you will receive a page that says "Thank You" and provides you the opportunity to:

Repeat the survey for each surgery you have had (up to 5);

Provide the comments for the questions requesting more information -- city, state, type of procedure, year, or country. Click the email link to provide this information.

Return to the IAS "Patient Advocacy" website page to read more;

Return to the IAS home page

If you would like to have a copy of the final results sent to you via email, please contact us. Include in the subject: Informed Consent Survey Results. Otherwise, they will be posted on our website at a later date.

For anyone who has experienced more than five abdominal and/or pelvic surgeries and wishes to provide information for this survey, please contact us. Include in subject: More than Five Surgeries.

Informed Consent Survey

ONLY TAKE THIS SURVEY IF YOU HAVE HAD ABDOMINAL OR PELVIC SURGERY. Vote once for for each time you have had a separate procedure (limit 5). Check all boxes that apply. To record when/where and type of procedure, click submit -- follow the links.

1. YES, I have had abdominal or pelvic surgery
2. No I have NOT had abdominal or pelvic surgery
3. I knew beforehand that the procedure would include cutting (lysis) of adhesions
4. I am male
5. I am female
6. Prior to surgery I was provided with information about the risks of adhesions
7. Prior to surgery I was provided information about the risks of adhesions as part of the informed consent (consent to surgery)
8. Prior to surgery I was provided written information about adhesions
9. Prior to surgery I was told the information about adhesions
10. Prior to surgery I was shown a movie/ video which included information about adhesions
11. Prior to surgery I was told that adhesion barriers might be used
12. Prior to surgery I was told that adhesion barriers would not be used
13. Prior to surgery I was told nothing about adhesion barriers
14. This procedure was performed in the USA (please provide year and state)
15. This procedure was performed in Canada (please provide year and province)
16. This procedure was performed in Europe (please provide year and country)
17. This procedure was performed in another country (please provide year and country)
18. I consent to the use of this information and understand that individual information will not be published, but masked or aggregated with other information

Provide a copy of your Informed Consent Form

Note: At this time, we are only requesting this information for past abdominal or pelvic procedures.

· Mail to:

International Adhesions Society, c/o Synechion, Inc., 6757 Arapaho Rd., Suite 711, Dallas, TX 75248

· Fax: to: 972 931 5476

· Email: (scanned image) to Tracy.Joslin@adhesions.org

If you have copies of informed consent forms from more than one surgical procedure, we don’t mind if you make multiple submissions as long as it is for different surgical procedures.

Please complete one questionnaire for each Informed Consent form you submit. Thank you.

Disability Letters

We have finally been able to provide you with materials that can be printed for your use when taking information to your physician, your insurance company or Disability Benefit officers.

Please take a moment to look at these letters. We have also been able to provide you with a sample letter to assist you with preparing your own materials. You may print Dr. Wiseman's letter in its entirety for your personal use when preparing materials for your disability claim.

A BIG thank you to Beverly Doucette (WI Support Coordinator) for helping to prepare the Sample Letter and Guidelines information. Should you have any questions - please contact us.

Sample Benefits Letter

Disability Guidelines

Dear Benefits Officer - a letter from Dr. Wiseman & the IAS