R9-16-109. Informed Consent for Midwifery Services

A. A midwife shall obtain a written informed consent for midwifery services in a format provided by the Department that contains: 1. The midwife’s: a. Name, b. Telephone number, c. License number, and d. E-mail address; 2. The client’s: a. Name; b. Address; c. Telephone number; d. Date of birth; and e. E-mail address, if applicable; 3. An attestation that the client was: a. Provided the information required in R9-16- 108(C)(1); b. Informed of the emergency care plan as required in R9-16-108(D); and c. Given an opportunity to have questions answered, have an understanding of the information provided, and choose to continue with midwifery services; and 4. The signatures of the client and midwife and date signed. B. A midwife shall ensure that the written informed consent for midwifery services is placed in the client record. C. A midwife shall ensure that a copy of the written informed consent for midwifery services is provided to the: 1. Client, and 2. Department within five calendar days after a Department request.