{{ clinic_name }}
{% blocktrans with name=signed_by_name %}Dear {{ name }},{% endblocktrans %}
{% blocktrans with patient=patient.full_name_en %}Thank you for signing the consent form for {{ patient }}.{% endblocktrans %}
{% trans "Consent Details:" %}
| {% trans "Patient" %}: | {{ patient.full_name_en }} |
| {% trans "MRN" %}: | {{ patient.mrn }} |
| {% trans "Signed by" %}: | {{ signed_by_name }} |
| {% trans "Signed on" %}: | {{ signed_at|date:"F d, Y" }} {% trans "at" %} {{ signed_at|date:"g:i A" }} |
| {% trans "Consent Type" %}: | {{ consent.get_consent_type_display }} |
{% trans "A copy of this consent has been securely recorded in our system." %}
{% blocktrans with clinic=clinic_name %}If you have any questions, please contact {{ clinic }}.{% endblocktrans %}
{% blocktrans with clinic=clinic_name %}This is an automated confirmation from {{ clinic }}.{% endblocktrans %}