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STERILIZATION <br />PERFORMING AGENCY shall comply with all federal regulations applying to sterilization <br />procedures. <br />Prior to receiving a sterilization, a client shall sign a copy of the U.S. Department of Health and <br />Human Services (DHHS) sterilization consent form. The original of this form, with all required <br />signatures (including the physician's), shall be kept in the client's medical records. <br />SECTION III. BUDGET: <br />PERFORMING AGENCY shall adhere to the current schedule of allowable services and rates as <br />referenced in SECTION H. SPECIAL PROVISIONS, as amended and approved by the <br />RECEIVING AGENCY. <br />Total payments will not exceed $10,781.00. <br />i- <br />ATTACHMENT - Page 5 <br />