image of caduceus
Consent Form - Abortion Procedure on a Minor

This Form has been adopted by the Texas Medical Board in accordance with the requirements of §164.052(c), Texas
Occupations Code (enacted by SB 419, 79th Legislature, 2005) and is published in 22 Texas Administrative Code §165.6(f).

The purpose of this Form is to allow the physician to obtain the required consents for an abortion to be performed on an unemancipated minor. The form is available here:  Consent Form for Abortion Procedure on a Minor