201 KAR 20:640. Requirements for informed consent for licensed certified professional midwives

Section 1. (1) An LCPM shall obtain written informed consent from the individual receiving services. (2) The LCPM shall maintain a copy of the informed consent document in the individual's records. (3) The informed consent document shall include: (a) A description of the LCPM's education and credentials; (b) A description of the LCPM's statutory scope of practice, including a summary of the LCPM's limitations of skills and practices; (c) Instructions for obtaining a copy of 201 KAR 20:600 to 201 KAR 20:690; (d) Instructions for filing a complaint with the board of nursing; (e) A summary of a written protocol for emergencies, including transfer to a higher level of care; (f) A description of the procedures, benefits, and risks of birth in the client's chosen environment, primarily those conditions that may arise during delivery; (g) Disclosure of professional liability insurance held by the LCPM; (h) The financial responsibility of the client; (i) A summary of the requirements for consultation, referral, or transfer of care established by 201 KAR 20:670 and 201 KAR 20:690; and (j) Procedures established by the LCPM for consultation, collaboration, referral, or transfer of care to a physician or other appropriate healthcare provider.