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This document is a reporting form for the Induced Termination of Pregnancy used by the Kansas Department of Health and Environment. It collects information about the patient's demographics, pregnancy

How to fill out report of induced termination

How to fill out Report of Induced Termination of Pregnancy

1. Obtain the Report of Induced Termination of Pregnancy form from your healthcare provider or relevant authority.
2. Fill out your personal information, including your name, address, and contact details.
3. Provide details of the termination procedure, including the date, location, and method used.
4. Include the name and license number of the healthcare provider who performed the procedure.
5. Sign and date the form to confirm that the information provided is accurate.
6. Submit the completed report to the designated health department or regulatory body as required by your jurisdiction.

Who needs Report of Induced Termination of Pregnancy?

1. Individuals who have undergone an induced termination of pregnancy may need the report for personal medical records.
2. Healthcare providers may need the report to comply with state or national reporting requirements.
3. Regulatory bodies or health departments require the report for statistical tracking and public health monitoring.

People Also Ask about

What is the terminology for termination of pregnancy?

Abortion is a medical intervention provided to individuals who need to end the medical condition of pregnancy.

What is a certificate of spontaneous termination of pregnancy?

A "Miscarriage Certificate" or "Nonviable Birth Certificate" is a document that some states provide when a pregnancy ends in a miscarriage. A miscarriage, also called a "spontaneous abortion," is when a baby dies in the before it is able to survive on its own outside the .

What is another name for an induced abortion?

Vacuum aspiration is also used for induced abortion. Dilation and curettage (D&C): This is another in-clinic procedure. It is also called a dilation and evacuation (D&E) or dilation and extraction (D&E).

What is the description of induced abortion?

Description. induced abortion is the intentional medical or surgical termination of pregnancy for any reason. 1. induced abortion should be distinguished from spontaneous abortion (SAB), which describes spontaneous pregnancy loss, typically in the first trimester, also known as miscarriage.

How do you report induced termination of pregnancy?

Generally, the Report of Induced Termination of Pregnancy is Bled directly with the State registrar. In a few States, however, these reports are filed with the local registrar who then forwards them to the State registrar.

What is the protocol for pregnancy termination?

200mg mifepristone, followed by 400mg misoprostol (vaginal, buccal or sublingual) every 3 hours until pregnancy has passed. 25+1-28 weeks: 200mg mifepristone, followed by 200mcg misoprostol (vaginal, buccal or sublingual) every 4 hours until pregnancy has passed.

What is the difference between abortion and induced abortion?

An induced abortion is where a pregnancy is ended intentionally. A spontaneous abortion is where a pregnancy ends on its own — that is, without medical intervention — before 20 weeks of pregnancy. Induced abortion is often simply called “abortion.” Spontaneous abortion is another term for miscarriage.

How are abortions reported?

The CDC does not require states to submit abortion data, but most do so through state laws requiring abortion providers, hospitals and other medical facilities to submit regular reports. Certain localities also require abortion reporting.

For pdfFiller’s FAQs

What is Report of Induced Termination of Pregnancy?

The Report of Induced Termination of Pregnancy is a legal record that documents details surrounding the termination of a pregnancy, including medical and personal information related to the procedure.

Who is required to file Report of Induced Termination of Pregnancy?

The healthcare provider or facility that performs the induced termination of pregnancy is typically required to file the report.

How to fill out Report of Induced Termination of Pregnancy?

The report should be filled out by providing accurate and complete information as required by local laws, including patient details, date of the procedure, and medical reasons for termination.

What is the purpose of Report of Induced Termination of Pregnancy?

The purpose of the report is to track and monitor abortion statistics for public health, ensure compliance with legal regulations, and support the collection of data for research and policy-making.

What information must be reported on Report of Induced Termination of Pregnancy?

Information typically reported includes patient demographics, gestational age, reason for termination, method used, and any complications that arose during the procedure.