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ABORTION INFORMED CONSENT CERTIFICATIONState Form 55320 (R / 816) Indiana State Department of Health IC 163421.1(a)PURPOSE OF FORM: This form documents your voluntary and informed consent to an abortion
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Abortion informed consent certification is a document that confirms that a patient has been properly informed about the risks and benefits of the abortion procedure.
Healthcare providers who perform abortions are required to file abortion informed consent certification.
Abortion informed consent certification can be filled out by providing the necessary information about the patient's informed consent to the abortion procedure.
The purpose of abortion informed consent certification is to ensure that patients are fully informed about the abortion procedure before it is performed.
Information such as the patient's understanding of the risks and benefits of the abortion procedure, confirmation of counseling, and consent for the procedure must be reported on abortion informed consent certification.
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