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Midwife Consent for HIV Antibody Screening Mobile App

Use the Midwife Consent for HIV Antibody Screening mobile app with a smartphone or tablet to allow patients to give consent to have their blood tested for the antibody to the Human Immunodeficiency Virus (HIV) because the natural birth they are about to undergo could expose caregivers to infection. The patient agrees to be tested for everyone’s protection, the protection of their unborn child, protection of caregivers, and for the protection of the mothers and children who come after me.

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

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Take a peek inside the Midwife Consent for HIV Antibody Screening Mobile App

Included Features

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Included Fields

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

  • Ico statictext

    I give consent to have my blood tested for the antibody to the Human Immunodeficiency Virus (HIV)...

  • Ico statictext

    I understand that if the test results indicate that my blood contains antibodies to HIV, it means...

  • Ico statictext

    The potential consequences of this testing are:

  • Ico statictext

    Those encountered during the routine procedure of obtaining blood specimens.

  • Ico statictext

    Positive results of the ELISA, Western Blot, or other HIV tests must be reported to the State De...

  • Ico statictext

    The results of an HIV test become part of the midwife’s records.

  • Ico statictext

    I am aware that a positive HIV results indicates antibodies to the virus and is not indicative of...

  • Ico statictext

    My signature confirms that I have thoroughly read this consent form, I have asked all the questio...

  • Ico textbox

    Name:

  • Ico signature

    Signature:

  • Ico date

    Date:

  • Ico signature

    Midwife’s Signature:

  • Ico date

    Date:

  • Ico statictext

    Repeat HIV Testing Authorization:

  • Ico signature

    Signature:

  • Ico date

    Date:

  • ...and More!

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