Get Sterilization Consent Form (pdf) - Magnolia Health Plan

Completing the Sterilization Consent Form is an important step in the sterilization process. This guide provides clear, step-by-step instructions to help you fill out the form accurately and confidently, ensuring that all necessary information is included.

Follow the steps to complete your Sterilization Consent Form online.

1. Click ‘Get Form’ button to access the Sterilization Consent Form in an online editor.
2. Begin with the statement of person obtaining consent. Fill in the name of the doctor or clinic that provided the information about sterilization.
3. Indicate your understanding of the process by confirming your awareness that sterilization is permanent and that your decision is voluntary. Record any alternative temporary methods of birth control discussed.
4. In the section requiring personal details, specify your age (must be at least 21 years) and your birth date.
5. If applicable, fill in the name of the individual to be sterilized and the type of sterilization operation being performed.
6. If an interpreter assisted you, they should complete their statement by providing their name and the language used for translation.
7. Sign and date the document to confirm your consent and understanding of the procedure, noting that your consent remains valid for 180 days.
8. After completing the form, you can choose to save your changes, download the document, print it for your records, or share it with relevant parties.

Complete your Sterilization Consent Form online today to ensure all required information is accurately captured.