Louisiana Revised Statutes Tit. 40, § 1191.3. Notice of parental rights form

(1) A definitive statement that reads as follows: “This notice of parental rights form is required to be provided to you pursuant to Louisiana law.”

(2) A brief description of the provisions of this Part along with concise instructions for the patient to follow regarding how to properly complete the form and return it to the health facility in the event the patient desires to arrange for the final disposition of the miscarried child.

(3) A concise statement of the timelines that must be satisfied in order for the patient to arrange for the final disposition of the miscarried child.

(4) A listing of state, regional, or national grief counseling organizations that may provide counseling services concerning the death of a child.