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Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.)

State:
Connecticut
Control #:
CT-JD-PC-702
Format:
PDF
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Description

Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.) The Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.) is a form used in the state of Connecticut to allow a competent adult to be sterilized, or to permanently prevent reproduction. It is designed to be printed on legal-size paper. It requires the patient's signature, as well as the signature of two witnesses who are not related to the patient. The form also requires a signature from a physician, indicating that the patient has undergone a physical examination and is mentally competent to make the decision to be sterilized. The Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.) comes in two different versions: one for males and one for females. Both forms are identical except the gender-specific language used to describe the sterilization procedure.

The Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.) is a form used in the state of Connecticut to allow a competent adult to be sterilized, or to permanently prevent reproduction. It is designed to be printed on legal-size paper. It requires the patient's signature, as well as the signature of two witnesses who are not related to the patient. The form also requires a signature from a physician, indicating that the patient has undergone a physical examination and is mentally competent to make the decision to be sterilized. The Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.) comes in two different versions: one for males and one for females. Both forms are identical except the gender-specific language used to describe the sterilization procedure.

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Connecticut Application/Sterilization of Adult (Rev. 10/00. Print on legal-size paper only.)