Instructions for Form 193 Alabama Medicaid Agency Sterilization Consent Form - Alabama

Instructions for Form 193 Alabama Medicaid Agency Sterilization Consent Form - Alabama

This document contains official instructions for Form 193 , Alabama Medicaid Agency Sterilization Consent Form - a form released and collected by the Alabama Medicaid Agency. An up-to-date fillable Form 193 is available for download through this link.

FAQ

Q: What is Form 193?
A: Form 193 is the Alabama Medicaid Agency Sterilization Consent Form.

Q: What is the purpose of Form 193?
A: The purpose of Form 193 is to obtain consent for sterilization procedures under the Alabama Medicaid program.

Q: Who needs to fill out Form 193?
A: The person undergoing the sterilization procedure, their legal guardian if applicable, and the attending physician need to fill out Form 193.

Q: Is Form 193 specific to Alabama?
A: Yes, Form 193 is specific to the Alabama Medicaid program.

Q: What information is required on Form 193?
A: Form 193 requires information about the individual undergoing the procedure, their guardian if applicable, the attending physician, and details of the sterilization procedure.

Q: Are there any special requirements for filling out Form 193?
A: Yes, Form 193 must be filled out at least 30 days prior to the sterilization procedure, unless there are emergency circumstances.

Q: What should I do with the completed Form 193?
A: The completed Form 193 should be submitted to the Alabama Medicaid Agency.

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Instruction Details:

  • This 1-page document is available for download in PDF;
  • Actual and applicable for the current year;
  • Complete, printable, and free.

Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Alabama Medicaid Agency.

Download Instructions for Form 193 Alabama Medicaid Agency Sterilization Consent Form - Alabama

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  • Instructions for Form 193 Alabama Medicaid Agency Sterilization Consent Form - Alabama, Page 1
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