Ariz. Admin. Code § R9-16-109 - Informed Consent for Midwifery Services

A. A midwife shall obtain a written informed consent for midwifery services in a format provided by the Department that contains:

1. The midwife's:

a. Name,

b. Telephone number,

c. License number, and

d. E-mail address;

2. The client's:

a. Name;

b. Address;

c. Telephone number;

d. Date of birth; and

e. E-mail address, if applicable;

3. An attestation that the client was:

a. Provided the information required in R9-16-108(C)(1) ;

b. Informed of the emergency care plan as required in R9-16-108(D) ; and

c. Given an opportunity to have questions answered, have an understanding of the information provided, and choose to continue with midwifery services; and

4. The signatures of the client and midwife and date signed.

B. A midwife shall ensure that the written informed consent for midwifery services is placed in the client record.

C. A midwife shall ensure that a copy of the written informed consent for midwifery services is provided to the:

1. Client, and

2. Department within five calendar days after a Department request.

D. This Section is effective October 1, 2013.

Notes

Ariz. Admin. Code § R9-16-109

Adopted effective March 14, 1994 (Supp. 94-1). R9-16-109 renumbered to R9-16-112 ; new Section R9-16-109 made by exempt rulemaking at 19 A.A.R. 1805, effective July 1, 2013 (Supp. 13-2). Amended by final expedited rulemaking at 28 A.A.R. 1119, effective 5/4/2022.