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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?

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

Included Features

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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!

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