Consent and Contract Packet

Midwifery Care NYC believes that clients and families and healthcare providers should work together to provide safe, high-quality care during pregnancy, with each party having certain rights and responsibilities: Rights and Responsibilities.

Initial consultation recap: Initial Consultation.

The MANA Statistics Project is being conducted by the Midwives Alliance of North America, your midwife contributes data to this project. After reading this letter, you will have the opportunity to ask questions and, if you so choose, to give your midwife verbal permission to enter information about your pregnancy and birth into the MANA Stats data collection system. No names or other identifiers are collected in this data registry: MANA Consent.

Patient Consent For Use and Disclosure of Protected Health Information: HIPAA Consent.

It is the responsibility of health care providers to inform childbearing families of their options in birth settings and the risks and benefits of choosing any of those settings. The setting chosen must be one considered safe and satisfying in meeting the needs expressed by the family: General Consent and Agreement.

Pre-authorization billing and other costs and services information: Billing Explanation.

Authorization for release of health information pursuant to HIPAA: Records Release Form.