Consent for the Removal of Implanon - Ky CHFS
I have had an opportunity to ask questions and discuss my concerns. After doing so, I give my consent to the removal of my Implanon. I plan to use _____ as my method of birth control. _____ _____ Patient Signature Date. The above patient signed the consent form in my presence after I counseled her and answered her questions. Witnessed by: ................
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