The IUD Insertion Informed Consent is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 1 signer (patient) and, by default, expires 30 days after it is sent if left unsigned. It covers consent, obgyn, iud, contraception, reproductive health. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.
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# IUD Insertion Informed Consent > **Important — not medical advice.** For use by a licensed provider; tailor to the patient, your protocols, and state law. **Patient Name:** ___________ **Date of Birth:** ___________ **Medical Record Number:** ___________ **Ordering Provider:** ___________ **Planned Procedure Date:** ___________ --- ## 1. Procedure I, the undersigned patient, consent to the insertion of an intrauterine device (IUD) by my healthcare provider. **Device Type:** ___________ An IUD is a small, T-shaped device placed inside the uterine cavity through the cervix. Hormonal IUDs release low-dose progestin (levonorgestrel) locally; copper IUDs are hormone-free and rely on copper's spermicidal effect. Both are long-acting, reversible contraceptive methods. The procedure typically takes 5–15 minutes and is performed in the office setting. Steps include: 1. A speculum is placed in the vagina to visualize the cervix. 2. The cervix is cleansed with antiseptic solution. 3. A tenaculum may be applied to stabilize the cervix. 4. A uterine sound measures the depth of the uterine cavity. 5. The IUD is loaded into a thin insertion tube and advanced through the cervical canal into the uterus. 6. The insertion tube is withdrawn, leaving the IUD in place. 7. The IUD strings are trimmed to an appropriate length. --- ## 2. Indication **Clinical indication:** ___________