The Louisiana Department of Health, office of public health, shall develop a form, and a notice of consequences of executing the form, for the purposes of implementing La. Rev. Stat. 40:34.5.1. The form shall include the following:

            (1) A declaration in authentic form by the husband or former husband presumed to be the father of the child that he is not the father of the child.

            (2) A declaration in authentic form by the biological father that he is the father of the child and that a certified report of blood or tissue sampling indicates by a ninety-nine and nine-tenths percentage point threshold probability that he is the biological father of the child.

            (3) A declaration in authentic form by the mother, husband or former husband presumed to be the father of the child, and the biological father of the child that each understands the form and has executed it voluntarily, and that each has received written notice of the consequences of executing the form.

            Acts 2018, No. 21, §1, eff. May 7, 2018.