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  • C015 1146 Sterilization Consent Form V.4.doc - Med-quest

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PROVIDER MANUAL: APPENDIX 3 CLAIMS FORMS Sterilization Required Consent Form DHS 1146 Form Pages C1 to C32 Pages C15.

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In 1974 states like Georgia, North Carolina, and Virginia required spousal consent for procedures, but by the end of the 1970s, the requirement had been challenged by a handful of court cases, and federal courts ruled state spousal consent laws unconstitutional – though the Supreme Court has never issued a judgment on ...

No physician shall perform a nontherapeutic sterilization on any person before twenty- four (24) hours following the giving of written informed consent by the person requesting such sterilization. History: Created 1974 Ky. Acts ch. 352, sec.

If a procedure is medically necessary, the consent of the patient's spouse in not required. The consent of the spouse is not required even if it incidentally will result in the sterilization of the patient.

A properly completed Sterilization Consent Form (HHS-687) is required for all sterilization-related claims. This includes hospital claims and professional services (surgeon and anesthesia). All other requirements and instructions for the Sterilization Consent Form must be followed to ensure the consent form is valid.

30 days (but not more than 180 days) must pass after the sterilization consent form has been signed. The 30 days starts the day after the consent is signed. Private Pay patients may request in writing that procedure be performed in less than 30 days.

STATEMENT OF PERSON OBTAINING CONSENT To the best of my knowledge and belief the individual to be sterilized is at least 21 years old and appears mentally competent. He/She knowingly and voluntarily requested to be sterilized and appears to understand the nature and consequences of the procedure.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232