Get Laminaria Consent Form - Camelback Family Planning

This guide provides a clear and detailed approach to completing the Laminaria Consent Form for second trimester abortion by dilation and evacuation at Camelback Family Planning. The instructions will help users navigate each section of the form effectively and confidently.

Follow the steps to fill out the Laminaria Consent Form online

1. Click ‘Get Form’ button to access the Laminaria Consent Form and open it in the editor.
2. Carefully read the description section of the form, which includes essential information about your pregnancy and the D&E procedure, including its duration and purpose.
3. Fill in the blank field for the estimated weeks of pregnancy based on the date of your last menstrual period.
4. Proceed to the procedure section and initial next to each item after reading to indicate your understanding of the medical history check, ultrasound, blood draw, and pelvic exam.
5. Continue to read about the cervical dilation options and initial where required, acknowledging your understanding of the methods and risks described.
6. Review the section detailing the risks associated with the D&E procedure and initial next to each risk to confirm your comprehension.
7. Fill out the consent for emergency contact by providing the name, relationship, address, and telephone numbers of the individual you authorize for emergency care.
8. Acknowledge your financial responsibilities by initialing the designated area on the form.
9. Indicate your transportation arrangement by selecting or filling out the section on whether you have a driver to take you home post-procedure.
10. Complete the certification statement about the basis for abortion decisions as required by Arizona law by initialing in the provided space.
11. Sign and date the form at the bottom, also providing printed name and witness signatures where necessary.
12. Once all fields are filled and reviewed, save your changes, and download or print the form for your records.

Complete your Laminaria Consent Form online to ensure a smooth process.