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Kansas24HourInformedConsent
Bringthisdocumentwithyoutoyourappointment
printedonWHITEPAPER
Pleasereadandinitialeachsectionandsignyourname
atthebottom.
DONOTmailtoComprehensiveHealthorPlanned
Parenthood.
TocomplywithKansasLaweffectiveJuly1,1998(amendedJuly1,2009July1,2011July1,2013July1,
2017),youmustreceivethisInformedConsentatleast24hourspriortoyourprocedure
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