Florida Department of State and Division of Library and Information Services

Reference: Ref-07926

Reference Name: The United States Department of Health and Human Services’ Consent for Sterilization Form - HHS-687 (10/12) (Consent for Sterilization Form)
Agency: 59 Agency for Health Care Administration
59G Medicaid

Modified Document(s): No Modified document(s).
Adopted Document(s):
2/6/2017 The United States Department of Health and Human Services’ Consent for Sterilization Form - HHS-687 (10/12)
Proposed Document(s):
2/3/2017 The United States Department of Health and Human Services’ Consent for Sterilization Form - HHS-687 (10/12)
Description: The United States Department of Health and Human Services’ Consent for Sterilization Form - HHS-687 (10/12)

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted		 Section Description ID Publish
Date
View Text Final
59G-1.045 		Medicaid Forms 19983084 Effective:
02/08/2018
View Text Final
59G-1.045 		Medicaid Forms 18753415 Effective:
04/05/2017



Under Florida law, E-mail addresses are public records. If you do not want your E-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.