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D by the person obtaining this consent. I have also read him/her the consent form in language and explained its contents to him/her. To the best of my knowledge and belief he/she understood this explanation. Interpreter Date Before signed the Name of Individual consent form, I explained to him/her the nature of the sterilization operation , the fact th.

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You can get a tubal ligation at a doctor's office, hospital, or health clinic. Many Planned Parenthood health centers also do some types of sterilization procedures. If your local Planned Parenthood doesn't do tubal ligation, they may be able to refer you to other health care providers in your area who do.

You get local anesthesia and your doctor makes a small cut near your belly button. The doctor brings your fallopian tubes up through the cut, then removes a short section of your tubes, blocks your tubes with clips, or removes the tubes completely. It usually only takes a few days to recover.

I understand that a hysterectomy (surgical removal of my uterus) is medically necessary and I have agreed to this operation. I acknowledge that I have been advised orally and in writing that the hysterectomy will cause me to be permanently incapable of reproducing (become sterile).

If your fallopian tube has grown back together after tubal ligation, it's possible you could have a full-term pregnancy. Some women also opt to have a tubal ligation reversal, where a doctor puts the fallopian tubes back together. This isn't always effective for women who want to get pregnant, but it can be.

A completed PM 330 Sterilization Consent Form must accompany all claims directly related to the sterilization surgery. This requirement extends to all providers, attending physicians, surgeons, assistant surgeons, anesthesiologists and facilities.

You can have a tubal ligation at any time. If you are interested in getting a tubal ligation, talk with your doctor or clinic. For Medicaid or other federal programs to pay for a tubal ligation, you must be 21 years of age and have signed a consent form giving permission 30 days before the procedure.

Sterilization is any medical or surgical procedure intended to render the client permanently incapable of reproducing. This includes vasectomies (CPT® code 55250), tubal ligations (CPT® codes 58600, 58605, 58611, 58615, 58670, and 58671), and hysteroscopic sterilizations (CPT® code 58565).

Yes. A qualified provider at any facility can perform the sterilization procedure as long as they have a copy of the original sterilization consent form.

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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