eLaws | eCases | Florida State | Florida Courts | Counties & Cities of Florida | Code of Federal Regulations |

Ref-07599 Abortion Clinic Incident Report Form, AHCA Form 3130-1003, July 2016

NOC Incident Reporting Form AHCA 3130-1003 July 2016.pdf

Form used to document incidents that result in serious injury at an abortion clinic. 2/24/2017

Visit the Official Version

Agency:: Agency for Health Care Administration
59A. Health Facility and Agency Licensing

Description:: Form used to document incidents that result in serious injury at an abortion clinic.

Related Rules

59A-9.029 Abortion Clinic Incident Reporting for Second Trimester Abortions

Related Notices

21987492.An Abortion Clinic Incident Report is required to be submitted within 10 days after an incident occurs. The Agency is revising the rule to require submission of an abortion clinic incident report online via the Adverse Incident Reporting System (AIRS) rather than by paper submission.