Against Medical Advice (AMA) Form Template for Midwifery Practices

Our AMA (Against Medical Advice) Form Template for Midwifery Practices is a comprehensive and easy-to-use document designed to assist midwives and their clients in documenting decisions to decline medical interventions or recommendations during pregnancy, labor, and delivery. This customizable form helps families make informed choices about their care, ensuring their preferences are clearly expressed and respected while maintaining legal and ethical boundaries.

This template provides a clear framework for documenting the refusal of medical advice and allows midwives to record client preferences for birth plans, including their wishes regarding interventions such as medication, monitoring, or transfer to a medical facility. It ensures that both the birthing person’s autonomy and the midwife’s professional responsibilities are respected in all situations.

Key Features Include:

• Comprehensive AMA Instructions: Includes sections to outline the patient’s specific refusal of medical advice, covering topics like labor interventions, hospital transfers, and emergency care decisions.
• Customizable Fields: Easily tailor the document to your practice’s specific needs and your clients' wishes.
• Witness Signature Section: Optional field to include a witness, ensuring transparency and legal validity.
• Liability Protection: Includes clear language regarding the midwifery practice’s liability, outlining responsibilities and release of liability for actions taken against medical advice.
• Review and Update Section: Provides space for clients to review and update the AMA form as their preferences evolve during pregnancy.
• Ethical and Legal Compliance: Ensures the document aligns with local and state guidelines for medical decision-making in midwifery care settings.

Key Features:

• Easy to Edit: Customize the template with your practice’s information and specific terms.
• Print-Ready: Once edited, you can print the document for physical use and signature.
• Fax-Friendly: Designed for easy faxing to clients or healthcare providers.
• Email-Friendly: Can be shared digitally, making it simple to communicate and formalize agreements remotely.

How It Works:

1. Purchase the Against Medical Advice (AMA) Form Template for Midwifery Practices.
2. Edit the template in Microsoft Word by adding your business name, contact details, and personalized terms.
3. Save and print the updated AMA form to formalize agreements with clients.

PLEASE NOTE:

• Personal Use Only: This template is for personal use only and cannot be resold, redistributed, or shared.
• Digital Product: This is a digital download; no physical product will be shipped.
• All Sales Are Final: Due to the nature of digital products, all sales are non-refundable.