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Midwife Sperm Sample Consent Mobile App

Intracervical Insemination (ICI) and Intrauterine Insemination (IUI) involve the placement of sperm or semen into the cervix or uterus for the purpose of becoming pregnant. We strongly encourage a thorough understanding of the risks and benefits to any given insemination sample, the STI-status of the sample to be used in insemination and advance planning for any legal issues that may arise with known donor samples. Use the Midwife Sperm Sample Consent mobile app with a smartphone or tablet to allow patients to read and consent to intracervical insemination (ICI) and intrauterine insemination (IUI)

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 Sperm Sample Consent Mobile App

Included Features

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Included Fields

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

  • Ico statictext

    Intracervical Insemination (ICI) and Intrauterine Insemination (IUI) involve the placement of spe...

  • Ico statictext

    I agree to provide either fresh semen or IUI-ready sperm samples, which I will bring with me to m...

  • Ico statictext

    I understand that <Insert Name> does not quantify sperm count or motility, provides no estimation...

  • Ico statictext

    I forever release and absolve <Insert Name>, and any of its staff and board members, from any and...

  • Ico textbox

    Client Name

  • Ico signature

    Signature

  • Ico date

    Date

  • Ico textbox

    CNM/RN Name

  • Ico textbox

    Signature

  • Ico date

    Date

  • ...and More!

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