By signing the form entitled "New Hampshire Midwifery Council Informed Consent for an Out-of-Hospital Vaginal Birth After Cesarean Section (VBAC)" the client:

1. (a) Shall acknowledge that:

   1. (1) She understands the information described in Mid 503.04(d);
   2. (2) She has read the documents described in Mid 503.04(a) and (b) and understands the significance of the facts and figures in both documents;
   3. (3) She has received and read Mid 503 and understands that the midwife practices according to its requirements; and
   4. (4) The midwife has answered her questions to her satisfaction; and

2. (b) Shall consent to midwifery services by the midwife signing the form for an out-of-hospital vaginal birth after a cesarean section.

   Source. #7931, eff 8-6-03, EXPIRED: 8-6-11

   New. #11095, INTERIM, eff 5-12-16, EXPIRED: 11-8-16

   New. #12040, eff 11-10-16

   Appendix

   Rule

   Specific State Statute which the Rule Implements

   Mid 501

   RSA 541-A:7

   Mid 502.01

   RSA 326-D:5, I (c); RSA 326-D:2, V

   Mid 502.02 (a) through (j) and (l) thru (n)

   RSA 326-D:2, V (a) and (b)

   Mid 502.02 (k)

   RSA 326-D:12, I (c)

   Mid 502.02 (o)

   RSA 326-D:12, I (d)

   Mid 502.02 (p) (1) and (2)

   RSA 326-D:12, I (f)

   Mid 502.02 (p) (3)

   RSA 326-D:12, I (a)

   Mid 502.02 (p) (4)

   RSA 326-D:12, I (e)

   Mid 502.02 (p) (5)

   RSA 326-D:12, I (h)

   Mid 502.02 (q) (1)

   RSA 326-D:12, I (f)

   Mid 502.02 (q) (2)

   RSA 326-D:12, I (e)

   Mid 502.02 (q) (3)

   RSA 326-D:12, I (h)

   Mid 502.02 (r) (1) and (2)

   RSA 326-D:12, I (g)

   Mid 502.02 (r) (3)

   RSA 326-D:12, I (h)

   Mid 502.02 (s)

   RSA 326-D:2, V (a) and (b)

   Mid 502.02 (t)

   RSA 326-D:12, I (b)

   Mid 502.02 (u) and (v)

   RSA 326-D:2, V (a) and (b)

   Mid 502.03 and 502.04

   RSA 326-D:2, V (a) and (b)

   Mid 502.05 and 502.06

   RSA 326-D:2, V (c)

   Mid 502.07 and 502.08

   RSA 326-D:2, V (a) and (b)

   Mid 502.09 and 502.10

   RSA 326-D:2, V (c)

   Mid 502.11

   RSA 326-D:2, V (a) and (b)

   Mid 503.01

   RSA 541-A:7

   Mid 503.02-Mid 503.06

   RSA 326-D:5, I(c)