The petition for determination of ability to give informed consent for sterilization shall be executed under oath and shall set forth:

1. 1. Person seeking sterilization or for whom sterilization is sought Name, age and residence of the person seeking sterilization or for whom sterilization is sought;

   [PL 1983, c. 459, §7 (NEW).]

2. 2. Parent, guardian or spouse Names and residences of any parents, spouse or guardian of the person seeking sterilization or for whom sterilization is sought;

   [PL 1983, c. 459, §7 (NEW).]

3. 3. Basis of petition A statement of the factors, including any listed in section 7004, subsection 2, and mental condition, when appropriate, which necessitate a determination of the ability of the person seeking sterilization or for whom sterilization is sought to give informed consent for sterilization;

   [PL 1983, c. 459, §7 (NEW).]

4. 4. Reasons for sterilization A statement of the reasons for which sterilization is sought; and

   [PL 1983, c. 459, §7 (NEW).]

5. 5. Person initiating petition The name, address, position and statement of interest of the person initiating the petition or any person assisting with a self-initiated petition.

   [PL 1983, c. 459, §7 (NEW).]

PL 1983, c. 459, §7 (NEW).