Signing Consent Forms on a Tablet: How Valid Is a Digital Signature?

Signing a consent form on a tablet means signing electronically, and European legislation establishes that an electronic signature cannot be denied legal effect or admissibility as evidence solely because it is electronic. What changes from one system to another is the type of signature and, above all, the evidence that is left behind: exactly which document was signed, when, from where and who was present. If the signature does not meet the requirements of an advanced signature, it is a simple electronic signature, and its strength depends on that evidence.

When written consent is needed

Spain’s Law 41/2002 (the patient autonomy law) establishes that consent shall be verbal as a general rule, but shall be given in writing for surgical procedures, invasive diagnostic and therapeutic procedures and, in general, whenever procedures are applied that carry risks or drawbacks with a notable and foreseeable negative impact on the patient’s health. In an aesthetic medicine, physiotherapy or nutrition clinic, deciding which treatments fall into that group is a clinical and legal decision for the clinic itself.

This article deals with the other half of the question: once it has been decided that a document is to be signed, how to do it without paper and with sufficient proof.

The three types of electronic signature

The legal basis for electronic signatures in the European Union is Regulation (EU) No 910/2014, known as the eIDAS Regulation, and in Spain it is complemented by Law 6/2020 on electronic trust services. The Spanish law does not repeat the Regulation: it complements it in the aspects the Regulation has not harmonised. The Regulation distinguishes three levels:

Type	What the Regulation says
Electronic signature (what is usually called simple)	Data in electronic form which are attached to or logically associated with other data in electronic form and which are used by the signatory to sign.
Advanced electronic signature	One that is uniquely linked to the signatory, is capable of identifying them, is created using data that the signatory can, with a high level of confidence, use under their sole control, and is linked to the data signed in such a way that any subsequent change is detectable.
Qualified electronic signature	An advanced signature that is created by a qualified signature creation device and which is based on a qualified certificate for electronic signatures.

On their effects, Article 25 of Regulation (EU) No 910/2014 says that an electronic signature shall not be denied legal effect and admissibility as evidence in legal proceedings solely because it is in an electronic form or because it does not meet the requirements for qualified electronic signatures. It adds that a qualified electronic signature shall have the equivalent legal effect of a handwritten signature. Article 46 of the Regulation says the same of electronic documents: they shall not be denied legal effect and admissibility as evidence solely because they are in electronic form.

In practice, at the clinic: a simple signature cannot be denied effect or admissibility as evidence for not being qualified, but nor does it have the equivalence to a handwritten signature that the Regulation grants to the qualified one; if someone challenges it, what upholds it is the evidence that accompanies it. Which level of signature each document in your clinic needs is something worth deciding with your adviser.

What makes a simple signature strong: the evidence

A well-implemented simple signature stores, alongside the pen stroke, everything needed to reconstruct what happened:

• The exact document. A digital fingerprint (hash) of the signed text, to show that it did not change afterwards.
• When. Date and time of the signature.
• Through which channel. On the clinic’s tablet or remotely with a personal link.
• Who was present. The team member who assisted with the signing.
• From where. The IP address and the browser of the device.
• That nobody touches it afterwards. The signed document is locked: if something needs correcting, another document is made.
• A copy for the patient. The signatory receives their signed copy.

In the consultation or remotely

In the consultation, the usual approach is for reception or the practitioner to open the already completed document, explain it to the patient and hand them the tablet to sign with their finger or a stylus. The key evidence here is who assisted with the signing and on which device.

Remotely, the patient receives a personal link and confirms with a code. This lets them read the document calmly at home before a treatment, or sign an authorisation that was forgotten in the consultation. What matters here is which mailbox the code reached and from which connection it was accepted.

In both cases, the patient should be able to read the whole document before signing, and not just a box for the signature.

How Mi Clínica does it and what it is not

In Mi Clínica, documents fill themselves in with the patient’s, the clinic’s and the practitioner’s details, including their professional licence number. They are signed on the tablet or remotely; they are stored signed and a signed copy is emailed to the person who signed. The remote signing link is sent by email or by WhatsApp from the clinic’s WhatsApp, and the one-time code goes to the patient’s email address.

The signed PDF stores evidence: channel, who assisted with the signing, IP address, browser and hashes. When the document leaves draft status it is frozen: it can no longer be deleted or changed. You can use the standard templates or duplicate them and adapt them with your clinic’s text, because the final legal text of each document is supplied by the clinic with its templates. And there is a list of what is outstanding: signatures and consent forms still missing.

What it is not, said just as clearly: Mi Clínica’s signature is a simple electronic signature with evidence. It does not by itself prove the identity of the person signing, because it does not use an electronic ID card, a qualified certificate or a qualified time stamp. It is neither an advanced nor a qualified signature. If your adviser tells you that a document needs one of those levels, you will have to use another tool for that document.

Typical mistakes

• Signing a generic template without the patient’s name or the specific treatment.
• Handing over the tablet without explaining the document. The signature does not replace the practitioner’s prior information.
• Correcting a document that has already been signed. If something was wrong, it is cancelled and another is signed; the original is kept.
• Not giving the patient a copy. It is the first thing they will ask for if a doubt arises.
• Mixing up authorisations. Consent to treatment does not authorise using photos on social media; we explain this in before-and-after patient photos.

And if you are choosing software, signing is only one piece: review the rest in what clinic management software should have.

Sources consulted

Checked on 9 October 2026. We link to the original source so that you can consult the current text.

• Reglamento (UE) n.º 910/2014, relativo a la identificación electrónica y los servicios de confianza (eIDAS). BOE (DOUE).
• Firma electrónica: base legal. Gobierno de España · Portal de Firma Electrónica.
• Ley 6/2020, reguladora de determinados aspectos de los servicios electrónicos de confianza (texto consolidado). BOE.
• Ley 41/2002, básica reguladora de la autonomía del paciente (texto consolidado). BOE.