Section R9-16-109. Informed Consent for Midwifery Services

A.      A midwife shall obtain a written informed consent for mid- wifery 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 file.

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.

D.      This section is effective October 1, 2013.

Historical Note

Adopted effective March 14, 1994 (Supp. 94-1). R9-16- 109 renumbered to R9-16-112; new Section R9-16-109 made by exempt rulemaking at 19 A.A.R. 1805, effective July 1, 2013 (Supp. 13-2). Manifest typographical errors corrected in subsections (A)(3)(a) and (b) to rule Section reference of incorrect Chapter number; request made by department at file number R13-232 (Supp. 13-3).