Section 34-23A-37 - Information collection form.
34-23A-37. Information collection form. The Department of Health shall prepare a reporting form for physicians which shall provide for the collection of the following information:
(1) The number of females to whom the physician provided the information described in subdivision 34-23A-10.1(1); of that number, the number provided by telephone and the number provided in person; and of each of those numbers, the number provided in the capacity of a referring physician and the number provided in the capacity of a physician who is to perform the abortion;
(2) The number of females to whom the physician provided the information described in subdivision 34-23A-10.1(2); of that number, the number provided by telephone and the number provided in person; of each of those numbers, the number provided in the capacity of a referring physician and the number provided in the capacity of a physician who is to perform the abortion; and of each of those numbers, the number provided by the physician and the number provided by an agent of the physician;
(3) The number of females who availed themselves of the opportunity to obtain a copy of the printed information described in § 34-23A-10.3, and the number who did not; and of each of those numbers, the number who, to the best of the reporting physician's information and belief, went on to obtain the abortion;
(3A) The number of females who availed themselves of the opportunity to view a sonogram of her unborn child pursuant to § 34-23A-52, and the number who did not; and of each of those numbers, the number who, to the best of the reporting physician's information and belief, went on to obtain the abortion;
(4) The number of abortions performed by the physician in which information otherwise required to be provided at least twenty-four hours before the abortion was not provided because an immediate abortion was necessary to avert the female's death, and the number of abortions in which such information was not so provided because a delay would create serious risk of substantial and irreversible impairment of a major bodily function;
(5) The name of hospital or physician office;
(6) The date of report by month, day, and year; and
(7) A unique patient number that can be used to link the report to medical report for inspection, clarification, and correction purposes but that cannot, of itself, reasonably lead to the identification of any person obtaining an abortion.
Source: SL 1998, ch 209, § 4; SL 2004, ch 234, § 3; SL 2008, ch 174, § 2.