Update to Consent for Sterilization Form


Effective June 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) Form 1723: Consent for Sterilization will be replaced with Form HHS-687: Consent for Sterilization. Providers should ensure that the current version of the form is used to document consent by checking the expiration date of the form.

The new form is available in the Appendices Section of the Physicians, Laboratories and Other Professionals and Hospital Services provider manuals, published on the agency website at www.scdhhs.gov/.

This form is required for sterilizations reimbursed through either the fee-for-service Medicaid program or a Medicaid Managed Care Organization (MCO).

If you have any questions concerning this announcement, please contact the Provider Service Center at (888) 289-0709.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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