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Despite numerous, sincere efforts to convince a 40 year old man to consent to EMS treatment and transport, he refuses. After explaining the potential consequences of his refusal and determining that he has decision-making capacity, you aks him ot sign and EMS refusal from, but he refuses to do that as well. You should:
ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign.