Risk management
Client Informational Handouts
Clear, consistent, and accessible written information helps clients make informed choices and reduces the risk of misunderstandings. This page is designed to support midwives and birth centers in creating effective client handouts that both educate and protect.
Why Client Handouts Matter for Risk Management
Client handouts are more than just educational tools — they are an essential part of informed choice and documentation. Well-designed handouts:
- Help clients retain important information about care, procedures, and emergencies.
- Reinforce key messages discussed verbally.
- Reduce the risk of miscommunication and legal exposure.
- Provide evidence that information was shared, supporting your documentation of informed consent.
In the event of a complaint or legal action, a signed or dated handout can demonstrate that the client was provided with appropriate information and guidance.
Required Client Informational Handouts in Washington State
Washington State law and midwifery rules require that clients be given specific written information. There are additional client handouts that are a good idea for all practices to have. Below is a summary of the core client handouts required by law, as well as others that are recommended by the JUA.
For Licensed Midwives
As required by RCW 18.50 and WAC 246-834
Must have these client handouts:
- Midwife Qualifications (RCW 18.50.105)
- Parent Information for a Positive Down Syndrome Diagnosis (DOH-specific handout) (RCW 18.50.170)
- Prenatal Testing (RCW 70.54.220 and WAC 246-680)
- Cord Blood Banking/Donation (RCW 70.54.220)
- Newborn Screening Tests (WAC 246-329-085)
- Notice of Privacy Practices
Good idea to have these client handouts:
- Services Provided by the Midwife
- Definition of a Low-Risk Client
- Ineligibility for Midwifery Services
- Benefits and Risks of Labor and Birth Outside of the Hospital
- Client Responsibilities
- Financial Agreement
- Prenatal Warning Signs/When to Call the Midwife
- HIV Testing
- Neonatal Emergencies
- Parent Information for Newborn Care
- Newborn Hearing Screening
- Child Passenger Restraint Systems
- Postpartum Warning Signs for Client & Baby/When to Call the Midwife
- How to Provide Feedback on Your Care
- Complaint Resolution
- Vaccination Information Sheets for any vaccines administered by the midwife
For Licensed Birth Centers
As required by RCW 18.46 and WAC 246-329
Must have these client handouts:
- Parent Information for a Positive Down Syndrome Diagnosis (DOH-specific handout) (RCW 18.46.150)
- Client Bill of Rights (WAC 246-329-085)
- Notice of Privacy Practices
Good idea to have these client handouts:
- Services Provided by the Birth Center
- Qualifications of Clinical Staff, Consultants and Related Services/Institutions
- Definition of a Low-Risk Client
- Ineligibility for Birth Center Services
- Client Responsibilities
- Benefits and Risks of Birth Center Labor and Birth
- Financial Agreement
- Availability of Rapid HIV Testing
- Neonatal Emergencies
- Newborn Hearing Screening
- Complaint Resolution
- Washington State Complaint Hotline
- Advanced Directives
- Child Passenger Restraint Systems
How to Develop or Revise a Client Informational Handout
1
Define the Purpose – What do you want the client to understand or be able to do?
2
Use clear, plain language that is accessible to a lay audience. Aim for a 6th-9th grade reading level. (There are lots of readability checkers online.)
3
Include Key Points – Use bullets, bold text, and subheadings to highlight crucial information.
4
Incorporate Visuals (if helpful) – Diagrams, simple icons, or QR codes can aid understanding.
5
Translate as Needed – Consider the languages spoken in your client population.
6
Test for Comprehension – Have someone outside your practice read the handout and summarize it.
7
Keep It Updated – Review annually or as guidelines change.
Templates and Examples
The sample documents, templates, and guidance provided by the Washington JUA are intended for informational and educational purposes only. They do not constitute legal advice, clinical directives, or regulatory requirements. Each midwifery practice is responsible for reviewing and adapting these materials in accordance with current Washington State laws, professional standards, and the specific needs of their practice. The Washington JUA assumes no responsibility for how these resources are used or interpreted.
Templates
Examples
Frequently Asked Questions
Do clients have to sign handouts?
Not always, but it’s best practice when the handout conveys risk information or instructions related to informed consent, transfer, or refusal of care. A signature or initials can confirm that the handout was received and reviewed.
What’s the difference between a handout and an informed consent form?
A handout provides general information. An informed consent form documents a specific decision, such as agreeing to a procedure or declining a recommended treatment.
Can I use handouts from other sources?
Yes, but be sure to review them for medical accuracy, relevance to your practice, and compliance with Washington regulations. Customize as needed to reflect your practice policies.
How often should I update my client handouts?
Review your handouts at least once a year or whenever there is a change in clinical guidelines, state regulations, or your practice policies. Regular updates help ensure your information remains accurate and legally defensible.
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