Fillable Printable Abortion Consent Form - Louisiana
Fillable Printable Abortion Consent Form - Louisiana
Abortion Consent Form - Louisiana
DEPARTMENT OF HEALTH AND HOSPITALS
OFFICE OF PUBLIC HEALTH
DIVISION OF RECORDS AND STATISTICS
Instructions for Completing the
Acts 2007, No. 281 Section 1 amends and reenacts R.S. 40:1299.35.6 to provide for:
...Informed consent of a woman upon whom an abortion is to be performed or induced; to require that certain
to require publication and provision of certain information and materials; to require certain information in cases
of medical emergency; to require certain reports; to provide for civil and criminal penalties and sanctions; to
provide for severability, construction, and right of intervention; and to provide for related matters.
The form is an important legal document.
! " # $
!%"
Vital Records Registry
P. O. Box 60630
&'(!)*+-*
/;*<=>+?<;**
@ !
@C@@@
/ = " "
D
"
@C@@@
" "
D
" E
The form is a snapset composed of an instruction
C
@F
@
"$
#
DC +- /% @ # = +; !
@!DC+-
@
$!
@!DC+-
!"#$%&'
DEPARTMENT OF HEALTH AND HOSPITALS
OFFICE OF PUBLIC HEALTH
()*+,-
.)*-
))++/(,*01++0)(,
*0,0))*.(,.(*0(,*+)**0
. ) 0+ + 2,0 *0,0) 0.+
*030((0*4301
!"#$%&'
1+))/2/(.))*(.)56+0
(+*777777777777777777777777777777777777777777./+8+49-7777+
(+*/+(+:7772(+*1
G
#
G
!"
G
#
G
@/><="
H
+#
>#"
I@"
G
#
G
#"
G
!%D%DJ"
J
G
#
G
#H
#H
@KK@
H
)-
1+))/2/(.))*(.)56+0
(+*777777777777777777777777777777777777777777./+8+49-+
(+*/+(+:7772(+*:77730)2+(+*
8*+)2.;)<4.;)0).20.+*91
G
#L
G
#
alternative.
G
#
/@=
G
#@
@
)-
1+))/2()/(,.)56+0(+.
*777777777777777777./+8+49-7777777+(+*/+(+:77777
2(+*:77777777730)2+(+*8*+)2.))<4.
;)0).20.+*91
G
#M!L"!QU
W@X
#
-777777777777777777777-777777777711118)9
)-