Medium

Available on

Apple Android Windows

Informed Disclosure Consent for Midwifery Care Mobile App

Use the Informed Disclosure Consent for Midwifery Care mobile app to complete and acknowledge an informed consent. Pregnancy and Childbirth is a profound emotional, spiritual and physical experience which has significant meaning to the mother, her family, and her community. Birth is a normal life process and not an illness. The birth process works best when unnecessary intervention is avoided. We believe that it is every woman’s responsibility to educate herself regarding all aspects of her healthcare and we facilitate that process. She is the primary decision maker regarding her care. Continuity of personalized, individualized healthcare is one of the most important advantages of midwifery care. Midwives encourage family centered care. The app covers philosophy, licenses, education and background, services provided, the health insurance portability and accountability act (HIPAA), consultation/transfer of care, risks, required tests/treatments, authorization to treat, grievances and consent.

GoCanvas has a collection of apps developed for Midwives and Doulas. They are all Free with your GoCanvas Subscription. Check them out in our Application Store!

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the Informed Disclosure Consent for Midwifery Care Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    Pregnancy and Childbirth is a profound emotional, spiritual and physical experience which has sig...

  • Ico multiline

    Licenses, Education and Background:

  • Ico statictext

    Prenatal visits are conducted at a minimum once every 4 weeks until 28 weeks gestation, once ever...

  • Ico statictext

    We will provide ongoing written and verbal information and education relating to all aspects of t...

  • Ico statictext

    One prenatal home-visit prior to 35 weeks.

  • Ico statictext

    Labor and birth/delivery and initial newborn care in home.

  • Ico statictext

    Postpartum and newborn care/visits which generally occur on day 1 or 2 and day 3 or 4, 1 or 2 wee...

  • Ico statictext

    hour availability to a Midwife.

  • Ico signature

    HIPAA gives you rights regarding your protected health information (PHI).

  • Ico signature

    A licensed Midwifes’ scope of practice is limited to normal pregnancy and well women care.

  • Ico signature

    Birth is generally a natural and safe process.

  • Ico signature

    I understand that there are potential risks to myself and/or my baby during pregnancy, labor, del...

  • Ico signature

    I understand that there is the possibility of a delay of additional medical treatment for myself ...

  • Ico signature

    Blood type and RH factor, CBC, Syphilis, Rubella Titer, Antibody Screen, HIV, Hepatitis B & C, Ur...

  • Ico signature

    I understand that the above tests are highly recommended and that there may be additional testing...

  • Ico signature

    I authorize any member of the birth team of (Insert Midwife Company Name) to treat me and my baby...

  • Ico signature

    If you have a grievance, please attempt a resolution with us first, knowing that we will make eve...

  • Ico statictext

    I hereby agree to and understand this informed consent agreement.

  • Ico statictext

    If you have a grievance, please attempt a resolution with us first, knowing that we will make eve...

  • Ico textbox

    Client Name:

  • Ico signature

    Signature:

  • Ico date

    Date:

  • Ico textbox

    Midwife Name:

  • Ico signature

    Signature:

  • Ico date

    Date:

  • ...and More!

Related Health Care & Social Services Apps... and they're all free for GoCanvas subscribers!

App Name

Midwife Patient Information

Make it easy for patients to complete Midwife Patient Information using this mobile app and a smartphone or tablet, The ap...

App Name

Midwife Vitamin K Informed Consent

Newborn babies are born with little vitamin K and breastmilk is low in vitamin K. At birth the baby’s intestinal tract has...

App Name

OB Questionnaire Midwife

The purpose of obtaining the information in the OB Questionnaire Midwife mobile app is to develop a comprehensive picture ...

App Name

Midwife PDR Consent

This Midwife PDR Consent Mobile App allows midwives and birthing centers to collect and share medical health data with the...

App Name

Midwife Nitrous Oxide Informed Consent

The Midwife Nitrous Oxide Informed Consent mobile app makes it easy for patients to give their consent when using the gas ...

App Name

Assertion to Decline On-Going Require...

Midwives can use the Assertion to Decline On-Going Required Tests Midwife mobile app with a smartphone or tablet to have...

App Name

Birth Doula Data Collection Form

Please have Doulas answer all applicable items in each category provided in the Birth Doula Data Collection Form mobile a...

App Name

Doula Hospital Release Form

The Doula Hospital Release Form mobile app captures an authorizing signature allowing hospital to pass name and limited ev...

More Information