Procedure to insert implant in breast of patient: Contents of explanation form and consent form; fee for forms.
1. The Health Division shall prepare and provide to physicians upon request:
(a) An explanation form for a procedure to insert an implant in the breast of a person which includes:
(1) An explanation of the advantages, disadvantages and risks associated with a procedure to insert an implant in the breast of a person, including any known side effects; and
(2) Any other information the Health Division determines to be useful to a person contemplating a procedure to insert an implant in the breast; and
(b) A consent form for a procedure to insert an implant in the breast of a person which includes:
(1) The nature and consequences of the procedure;
(2) The reasonable risks, possible side effects, benefits and purposes of the procedure; and
(3) Any alternative procedures available.
2. The Health Division shall revise the explanation form and consent form as necessary to keep the medical information current.
3. The Health Division shall charge and collect a fee for all forms distributed pursuant to this section that is adequate to cover the cost of producing the forms.
Last modified: February 26, 2006