The written informed choice and disclosure statement which
has been approved by the department shall include:
(1) an informed choice statement containing:
(A) statistics of the midwife's experience as a midwife;
(B) the date of expiration of the midwife's license;
(C) the date of expiration of the midwife's adult and
infant cardiopulmonary resuscitation and neonatal resuscitation certification;
(D) the midwife's compliance with continuing education
(E) medical backup arrangements; and
(2) a disclosure statement, which includes the legal
requirements of the midwife and prohibited acts as stated in the Act.
The disclosure statement may not exceed 500 words and must be in Spanish
and English; and must contain;
(3) information on where to file a complaint against
a licensed midwife, including the name, mailing address and telephone
number for the department.