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LOVERS LANE BIRTH CENTER GENERAL CONSENT FOR MATERNITY CARE Being in approximately the ___________ week of pregnancy and being ___________ years of age, I hereby request enrollment in Lovers Lane Birth Center with the fo
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Document Date: 2012-06-25 17:42:51


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Facility

Lovers Lane Birth Center / /

MedicalCondition

uterine rupture / amnionitis I / allergic reaction / allergies / anaphylactic shock / mental retardation / convulsions / amniotic fluid embolism / HIV / birth injuries / placental abruption / infection / cardiac arrest / respiratory distress syndrome / coma / infections / amnionitis / respiratory distress / /

MedicalTreatment

Intravenous infusions / /

Organization

Lovers Lane Birth Center / /

Person

H. Necessary / /

Position

physician / transferring physician / /

Product

pitocin / /

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