Midwife Consent Documents

$200.00

Consent documents written for homebirth midwives & students!

These are the documents that I use in my own practice, tried and true! Most recently updated in 2025 to include Illinois and Iowa statutes and rules. These documents are written with neutral pronouns.

Please do not share these forms with other midwives. I’ve worked really hard on these over the years! Please refer them to my site for purchase. Students, please do not plagiarize these forms by submitting them as your own.

Once you complete your purchase, you will receive Word documents of nineteen consent documents. Add your logo, name, and edit this document to include information specific to you and your practice. Spaces where an edit is needed specifically say “edit” so you can easily search and edit the documents. The informed disclosure is more personalized to me and my practice - difficult to write for an unknown!, but I still hope the outline provides an easy avenue for you to input your own information.

Disclaimer: mistakes happen! I make no claim that these are perfect. It is up to you, the purchaser, to read through and edit accordingly. I highly recommend you create a footer on all your paperwork to track updates and commit to updating your paperwork annually (you’ll note I did this for you :) they’re easy to edit!). If you do find any spelling or grammatical errors, please let me know at sarahmoorecpm@gmail.com.

If there are consents you wish were included in your package, let me know! I’m so happy to add more! sarahmoorecpm@gmail.com

This package includes:

  1. Informed Disclosure: This is the most editing you will have to do outside of preferred edits to other documents. This document includes philosophy of care, training, plan of care, team, transfer of care, practice management, and relationship.

  2. HIPAA Disclosure: Discusses HIPAA regulations and guidelines and applies them to the practice of midwifery. Includes several spaces for clients to initial and consent to various aspects of sharing personal health information.

  3. Criteria for Risking Out and Transferring Care: Includes specific plans in place - both non-emergent and emergent - and consent for records to be sent. Please note, there are specific notes in this file regarding care in Illinois and Iowa. You can search and make adjustments accordingly.

  4. Responsibilities of Homebirth Clients: A bullet pointed list of expectations for the birthing person including attending scheduled visits, caring for themselves as best as possible, arranging for care for older children and animals, etc.

  5. Financial Contract: This document includes what’s included and not included in the global fee, discounts, bartering, refunds, late to care, delinquency, etc.

  6. Frequently Asked Questions: Easily editable to suit your needs!

  7. Waterbirth Consent: This document reviews benefits and risks of waterbirth, eligibility, logistics, midwife’s training, etc. Citations include ACOG, Bovbjerg et al., and Waterbirth International. 

  8. Fetal Anatomy Scan Consent: Discusses reasons, benefits, and risks. Also reviews reasons for follow up.

  9. Gestational Diabetes Consent: Using the most up to date information from Evidence Based Birth and Lily Nichols, this document discusses risks of GDM and testing approaches. It includes various options for clients to select. Includes Fresh Test! Citations include Evidence Based Birth, HAPO Research Group, & Lily Nichols.

  10. Rhogam Consent: This document provides education on alloimmunization, recommended Rhogam schedule, risks and benefits of Rhogam, as well some information on Unity Screen. There are a variety of consent selections. Citations include ACOG, Evidence Based Birth, and USPSTF. 

  11. Group B Strep Consent: This consent reviews Early-Onset and Late-Onset GBS, testing, prophylaxis, and gives a variety of consent options. Citations from Evidence Based Birth, CDC, and ACOG.

  12. Vitamin K Consent: Educates on the various forms of VKDB, reviews IM, oral, and declining. Debunks myths. Reviews normal newborn behavior and when to seek help. Citations from Evidence Based Birth, CDC, AAP, and WHO. 

  13. Critical Congenital Heart Disease (CCHD) Screening Consent: This consent reviews incidence and screening protocol. Citations include AAP, CDC, Wisconsin’s Shine Project.

  14. Newborn Metabolic Screening Consent: This document discusses screening protocol, conditions screened for, and cost for the testing in the states of Illinois and Iowa. Includes a variety of consent options. Citations include AAP, CDC, Illinois and Iowa Departments of Public Health, and RUSP. 

  15. Hearing Screening Consent: This consent assumes the midwife is performing newborn hearing screening using an OAE machine and reviews the national EDHI guidelines, what to expect during the screen, and discusses cCMV. Includes consenting or declining to the screen. Citations include AAP, CDC, National CMV Foundation as well as Illinois and Iowa screening guidelines.

  16. Hearing Screening Consent (REFER): This consent is similar to the other Hearing Screening Consent but assumes the midwife is referring to another provider for the screen. Includes a request for the midwife to make a referral and declining the screen. Citations are the same. 

  17. Eye Ointment Consent: Discusses reasoning behind universal prophylaxis, data on incidence, risk of prophylaxis, as well as the alternative approach of comprehensive STI screening during pregnancy. Includes requirements for Illinois and Iowa. Citations include AAP, CDC, Evidence Based Birth, and USPSTF. 

  18. Records Request for previous or current pregnancy(ies): provides different options for what to share as well as expiration time frame for consent.

  19. Records Release for records to be sent to pediatrician: provides different options for what to share as well as expiration time frame for consent.

Consent documents written for homebirth midwives & students!

These are the documents that I use in my own practice, tried and true! Most recently updated in 2025 to include Illinois and Iowa statutes and rules. These documents are written with neutral pronouns.

Please do not share these forms with other midwives. I’ve worked really hard on these over the years! Please refer them to my site for purchase. Students, please do not plagiarize these forms by submitting them as your own.

Once you complete your purchase, you will receive Word documents of nineteen consent documents. Add your logo, name, and edit this document to include information specific to you and your practice. Spaces where an edit is needed specifically say “edit” so you can easily search and edit the documents. The informed disclosure is more personalized to me and my practice - difficult to write for an unknown!, but I still hope the outline provides an easy avenue for you to input your own information.

Disclaimer: mistakes happen! I make no claim that these are perfect. It is up to you, the purchaser, to read through and edit accordingly. I highly recommend you create a footer on all your paperwork to track updates and commit to updating your paperwork annually (you’ll note I did this for you :) they’re easy to edit!). If you do find any spelling or grammatical errors, please let me know at sarahmoorecpm@gmail.com.

If there are consents you wish were included in your package, let me know! I’m so happy to add more! sarahmoorecpm@gmail.com

This package includes:

  1. Informed Disclosure: This is the most editing you will have to do outside of preferred edits to other documents. This document includes philosophy of care, training, plan of care, team, transfer of care, practice management, and relationship.

  2. HIPAA Disclosure: Discusses HIPAA regulations and guidelines and applies them to the practice of midwifery. Includes several spaces for clients to initial and consent to various aspects of sharing personal health information.

  3. Criteria for Risking Out and Transferring Care: Includes specific plans in place - both non-emergent and emergent - and consent for records to be sent. Please note, there are specific notes in this file regarding care in Illinois and Iowa. You can search and make adjustments accordingly.

  4. Responsibilities of Homebirth Clients: A bullet pointed list of expectations for the birthing person including attending scheduled visits, caring for themselves as best as possible, arranging for care for older children and animals, etc.

  5. Financial Contract: This document includes what’s included and not included in the global fee, discounts, bartering, refunds, late to care, delinquency, etc.

  6. Frequently Asked Questions: Easily editable to suit your needs!

  7. Waterbirth Consent: This document reviews benefits and risks of waterbirth, eligibility, logistics, midwife’s training, etc. Citations include ACOG, Bovbjerg et al., and Waterbirth International. 

  8. Fetal Anatomy Scan Consent: Discusses reasons, benefits, and risks. Also reviews reasons for follow up.

  9. Gestational Diabetes Consent: Using the most up to date information from Evidence Based Birth and Lily Nichols, this document discusses risks of GDM and testing approaches. It includes various options for clients to select. Includes Fresh Test! Citations include Evidence Based Birth, HAPO Research Group, & Lily Nichols.

  10. Rhogam Consent: This document provides education on alloimmunization, recommended Rhogam schedule, risks and benefits of Rhogam, as well some information on Unity Screen. There are a variety of consent selections. Citations include ACOG, Evidence Based Birth, and USPSTF. 

  11. Group B Strep Consent: This consent reviews Early-Onset and Late-Onset GBS, testing, prophylaxis, and gives a variety of consent options. Citations from Evidence Based Birth, CDC, and ACOG.

  12. Vitamin K Consent: Educates on the various forms of VKDB, reviews IM, oral, and declining. Debunks myths. Reviews normal newborn behavior and when to seek help. Citations from Evidence Based Birth, CDC, AAP, and WHO. 

  13. Critical Congenital Heart Disease (CCHD) Screening Consent: This consent reviews incidence and screening protocol. Citations include AAP, CDC, Wisconsin’s Shine Project.

  14. Newborn Metabolic Screening Consent: This document discusses screening protocol, conditions screened for, and cost for the testing in the states of Illinois and Iowa. Includes a variety of consent options. Citations include AAP, CDC, Illinois and Iowa Departments of Public Health, and RUSP. 

  15. Hearing Screening Consent: This consent assumes the midwife is performing newborn hearing screening using an OAE machine and reviews the national EDHI guidelines, what to expect during the screen, and discusses cCMV. Includes consenting or declining to the screen. Citations include AAP, CDC, National CMV Foundation as well as Illinois and Iowa screening guidelines.

  16. Hearing Screening Consent (REFER): This consent is similar to the other Hearing Screening Consent but assumes the midwife is referring to another provider for the screen. Includes a request for the midwife to make a referral and declining the screen. Citations are the same. 

  17. Eye Ointment Consent: Discusses reasoning behind universal prophylaxis, data on incidence, risk of prophylaxis, as well as the alternative approach of comprehensive STI screening during pregnancy. Includes requirements for Illinois and Iowa. Citations include AAP, CDC, Evidence Based Birth, and USPSTF. 

  18. Records Request for previous or current pregnancy(ies): provides different options for what to share as well as expiration time frame for consent.

  19. Records Release for records to be sent to pediatrician: provides different options for what to share as well as expiration time frame for consent.