We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Executive Forms
  • Executive Department HHS Forms
  • Hhs-687 2010

Get Hhs-687 2010

NY BENEFITS PROVIDED BY PROGRAMS OR PROJECTS RECEIVING FEDERAL FUNDS. STATEMENT OF PERSON OBTAINING CONSENT CONSENT TO STERILIZATION I have asked for and received information about sterilization from . When I first asked Doctor or Clinic for the information, I was told that the decision to be sterilized is completely up to me. I was told that I could decide not to be sterilized. If I decide not to be sterilized, my decision will not affect my right to future care or treatment. I will not lose a.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the HHS-687 online

The HHS-687 form is a consent document that individuals must complete prior to undergoing a sterilization procedure. This guide will walk you through each section of the form, ensuring that you understand how to fill it out accurately and effectively.

Follow the steps to complete the HHS-687 effectively.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
  2. Begin filling out the 'Statement of Person Obtaining Consent' section. Here, you will need to provide the name of the doctor or clinic from whom you received information about sterilization. Ensure you understand that the decision to be sterilized is entirely yours.
  3. In the 'Consent to Sterilization' section, confirm your understanding of the permanency of sterilization, stating clearly that you do not wish to become pregnant or bear children. You will also reject any temporary birth control methods discussed with you.
  4. Specify the type of sterilization operation you agree to, and understand the associated risks, discomforts, and benefits. Make sure all your questions are answered satisfactorily.
  5. Indicate your date of birth and ensure you are at least 21 years old. Sign your name to confirm your consent and the date of signing.
  6. If applicable, complete the 'Interpreter's Statement'. The interpreter must provide their signature and confirm they have accurately translated the information provided to you.
  7. Fill out the 'Physician's Statement' section, where the physician validates the procedure. Ensure that the physician indicates whether at least thirty days have passed since signing the consent or if there are special circumstances requiring different provisions.
  8. Finally, review the entire form for completeness and accuracy. Once all sections are filled appropriately, you can save your changes, download, print, or share the completed form as needed.

To ensure proper documentation, complete the HHS-687 online today.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

Consent for Sterilization: Form HHS-687
CONSENT TO STERILIZATION. I have asked for and received information about sterilization...
Learn more
CONSENT FOR STERILIZATION
HHS-687 (04/22). Page 2. PAPERWORK REDUCTION ACT STATEMENT. A Federal agency may not...
Learn more
Drug Master Files Guidance for Industry
Comments and suggestions regarding this draft document should be submitted within 60 days...
Learn more

Related links form

Mark Hirschey Managerial Economics Pdf 2020 Abnkkbsnplako Pdf 2020 GTU/Name Correction/ 2265 2020 Meaforms 2020

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

In the United States, you do not need your husband's permission to get your tubes tied, as it is ultimately a personal decision. The HHS-687 consent for sterilization outlines your rights regarding reproductive choices. You can make this choice independently, ensuring you feel comfortable and informed about your options. If you have questions about the consent process, consult reliable resources or speak to your healthcare provider.

The medical code for sterilization varies depending on the specific procedure performed. Generally, ICD codes related to sterilization procedures fall under a specific range designated for reproductive health. For the most accurate coding, professionals should refer to the latest ICD coding manuals. Familiarizing yourself with the HHS-687 can also ensure that documentation aligns with medical coding standards.

For sterilization, obtaining informed consent is necessary to ensure patients understand the procedure and its consequences. The HHS-687 form is the official consent document used to capture this agreement. It includes essential information about the procedure, alternatives, and the risks involved. Therefore, using the HHS-687 form ensures all requirements are met and protects both the patient and the provider.

Yes, many healthcare providers observe a 30-day waiting period before performing a tubal ligation. This waiting period allows individuals time to reflect on their decision after signing the HHS-687 consent form. It's essential to speak with your healthcare provider for specifics regarding scheduling and any prerequisites related to tubal ligation procedures.

Consent to sterilization is the process where individuals agree to undergo sterilization after receiving full disclosure about the procedure. It ensures that patients are aware of the nature of the procedure, its permanence, and any associated risks. The HHS-687 form is commonly used to document this informed consent.

A request for sterilization refers to a formal petition by an individual seeking to undergo a permanent procedure to prevent future pregnancies. This request usually involves completing a necessary form, such as the HHS-687, which outlines the individual's understanding of the procedure and their rights. It is the first step in ensuring the individual is fully informed and consenting to the sterilization.

Some states mandate that spousal consent is necessary for sterilization procedures. These regulations can vary widely, and knowing your state's laws is essential. Always refer to local health authorities or consult with healthcare providers for accurate information regarding spousal consent in sterilization.

Typically, the consent for sterilization, such as the HHS-687, remains valid for a specific time frame dictated by state regulations and the health provider's policies. Generally, the consent is effective for the current period of treatment but may require renewal if significant time passes before the procedure. Always check with healthcare providers for specific guidelines and requirements regarding consent validity.

HHS, or the Department of Health and Human Services, is not a Medicare program. Instead, HHS oversees various health-related policies and public health initiatives, including aspects of Medicare. Understanding this distinction is crucial for individuals seeking information on health services and benefits available through the Medicare system.

Medicaid tubal consents typically remain valid as long as the conditions of consent are met and documented. However, it’s essential to check specific state regulations and guidelines regarding the validity period of consent forms like the HHS-687. Staying informed can help you maintain compliance and ensure that your consents are recognized by your healthcare provider.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get HHS-687
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
HHS-687
This form is available in several versions.
Select the version you need from the drop-down list below.
2012 HHS-687
Select form
  • 2012 HHS-687
  • 2010 HHS-687
Select form