This customizable document, Physician Responsibility for Obtaining Sterilization Consent, is taken from MCN Healthcare’s Outpatient Surgery and Ambulatory Services Policy and Procedure Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

MCN’s templates save you time, money and resources, rather than developing healthcare policy and procedure manuals from scratch.

Here is some sample content from Physician Responsibility for Obtaining Sterilization Consent:

	POLICY: It is the responsibility of the physician to obtain sterilization consents on all patients undergoing procedures that would render the patient incapable of child bearing. The original copy of the consent is to be placed on the chart before the surgical procedure is performed. Sterilization consents shall meet the guidelines set by Medicaid and State Regulations. Informed consents must be signed for all procedures. Elective sterilization; abdominal or laparoscopic tubal ligation, vasectomy, postpartum tubal ligation or tubal ligation with C-section: Private Insurance or Cash...
Second excerpt:
	...Insurance or Cash Patients: Must have state sterilization form and facility consent. Waiting period of 30 days may be waived to 72 hours three 3] days. Medicaid Patients: Same as above. May not waive the 30-day waiting period. Previously sterilized patients do not require sterilization forms. TURP and other GU procedures possibly leading to sterility, other than vasectomy, do not require sterilization forms. SUBJECT:PHYSICIAN RESPONSIBILITY FORREFERENCE #1008OBTAINING...