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Get and Sign CONSENT for STERILIZATION, F 01164, Wisconsin Dhs Wisconsin Form

Could decide not to be sterilized. If I decide not to be intended to be a final and irreversible procedure and the discomforts risks sterilized my decision will not affect my right to future care or treatment. I am at least 21 years of age and was born on on 20. Month Day Year date of sterilization I 4 hereby consent of my own I explained to him/her the nature of the sterilization operation free will to be sterilized by 5 doctor specify type of operation by a method called 6. Quired Ethnicity...

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