Sterilization Consent:
Tutorial on Completing the PM330
It is important to provide Family PACT clients seeking sterilization all the information they need to make the best choice for them. This tutorial explains the basics regarding obtaining proper consent for sterilization. It also demonstrates in detail exactly how to complete the sterilization consent form properly.
Click one of the links below to access the 20-minute tutorial.
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Right click the PowerPoint Presentation with Audio, and click on Save Target as which will save it to your computer. This may take some time. When you open it, it will open automatically in PowerPoint SlideShow.
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Or left click the PowerPoint Presentation without Audio. This is a PDF version with the script you can toggle on to read. Click on the dialogue option at the side of the PDF. That will reveal the script so you can follow along. If you see three little dots at the end of the script box, simply double-click your mouse to open the full script which you can scroll down to read.
Sterilization Consent: A Tutorial on Completing the PM330
PowerPoint Presentation with Audio (7MB) | PowerPoint Presentation without Audio (PDF 1MB)
ADDENDUM TO SLIDES 10-13 and 50-55 IN THE TUTORIAL:
Copies of the sterilization Consent Form (PM 330) can be downloaded (in English and Spanish) from the Forms page of the Medi-Cal website or ordered by calling the Telephone Service Center (TSC) at 1-800-541-5555.
Providers must supply their NPI number when ordering the form(s). The following information also may be requested:
- Date
- Name of document (sterilization Consent Form, PM 330)
- Name of provider/facility (registered provider name associated with the NPI)
- Complete shipping address: Street, city, state, ZIP code (P.O. Box not accepted)
- Quantity of forms requested
- Contact person and telephone number
Sterilization Booklets on male and female sterilization entitled Permanent Birth Control for Men and Women are available for download in English and Spanish on the DHCS website.
Attachments to print:
To obtain a Certification of Participation for this tutorial, you must complete and submit the Evaluation Form.
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This document was updated last at Wednesday, January 18, 2012