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What is pm330 consent form?

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.

How do I fill out a sterilization consent form?

I have decided to undergo the sterilization/re-sterilization operation on my own without any outside pressure, inducement or force. I declare that I/my spouse has not been sterilized previously (may not be applicable in case of re-sterilization). b. I am aware that other methods of contraception are available to me.

How long is a hysterectomy consent form good for?

I understand that I can change my mind at any time and that my decision at any time not to be sterilized will not result in the withholding of any benefits or medical services provided by federally funded programs. Specify Type of Operation consent expires 180 days from the date of my signature below.

pm330 consent form

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