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Patient Signature Committee

Purpose and Scope

The Patient Signature Forms Subcommittee is charged with overseeing the development of new documents, condensing the existing catalog of forms, editing and making recommendations for all forms requiring a patient signature, including, but not limited to consents, notifications, and/or acknowledgements.

Outcomes for this committee include:

  • Develop an organizational structure to manage/control form creation and/or electronic templates.
  • Review all forms requiring a patient signature prior to build or inclusion in the medical record to optimize operational flow and processes, to include, but not limited to who is responsible for signature capture, how form is included in medical record, and to ensure appropriate document standards are met.
  • Confirm appropriate reading level and usability of the form
  • Coordinate with information technology (IT) for technology enhancements, interface, and form development.
  • Confirm documents presented for consideration are consistent with VUMC existing or proposed policy and comply with regulatory/statutory standards.


The Patient Signature Forms Subcommittee reports to the Health Record Executive Committee under the auspices of the Medical Center Medical Board.


The Patient Signature Forms subcommittee meets the third Friday of every month.

Committee Members

Chair                                                                                              Janice Smith

Primary Staff                                                                                Angie Estes

EpicLeap HIM Team                                                                    Nancy Anderson 

Quality, Safety & Risk Prevention                                            Chad Fitzgerald 

Health IT Customer Relationship                                             Wendy Kiepek 

Manager Biomedical Informatics                                             Jake Lancaster

Legal Affairs                                                                                 Adrienne Kepner

VCH Administration                                                                    Chris Lee

Center for Health Information Management/OnBase          Diane Neel

Center for Health Information Management                         Gaye Smith

Patient Education                                                                        Lane Stiles

Main OR Administration                                                            Dave Wyatt

Ambulatory Leadership                                                             Rory Langefeld

VUMC Admitting                                                                         Marsha Kedigh

Provider                                                                                       Kevin Smith, MD