1When a spontaneous fetal demise occurs after a gestation of less than 20 completed weeks, the health care facility identified in Section 23383.33625(4), F.S., 25shall follow the provisions of that section and shall provide AHCA Form 3100-0006, January 2005, Notification of Disposition of Fetal Demise, to the mother for her completion. AHCA Form 3100-0006, January 2005 is incorporated in this rule by reference and available at http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/hospital.shtml, or from the Hospital and Outpatient Services Unit at 2727 Mahan Drive, MS #31, Tallahassee, FL 32308. A copy of the signed and completed form shall by retained in the mother’s medical record and shall be available for review by the Agency or Department of Health.
