Emergency Transport/Transfer Form
Informed Consent Form
These forms are required by NCM for graduation from the ASM program. They are a sample of what the student plans to use in future practice. These items must satisfy the requirements of both NARM and for the state in which the student plans to practice in the future. The student must NEVER indicate that she/he is a midwife prior to actual attainment of midwifery licensure or certification.
Sample Emergency Transport/Transfer Forms:
(This form is generally completed by the student in Module 8-MW250-Midwifery Protocols course):
Florida Emergency Transport Form
California Informed Disclosure and Care Outline
Sample Informed Consent Forms:
(This form is generally completed by the student in Module 8- HON390G: Midwifery Laws & Regulations course):
California Disclosure Form Outline
Midwifery Practice Guidelines:
To satisfy the ASM requirement, the student must write an official letter to NCM letting us know which state's Midwifery Practice Guidelines you are requried to practice under. The purpose of your letter is to let us know which guidelines you verify that you work under. If you will be practicing midwifery in a state that does not have official practice guidelines for midwifery, then your letter will let us know which practice guidelines from a state (in which midwifery is regulated), you will be using.
New Mexico Practice Guidelines
California Practice Guidelines
Laws and Statutes Governing Midwifery: