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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.
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.
