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Form ODM03197 Abortion Certification - Ohio
What Is Form ODM03197?
This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ODM03197?
A: Form ODM03197 is an abortion certification form used in Ohio.
Q: What is the purpose of Form ODM03197?
A: The purpose of Form ODM03197 is to certify that an abortion complies with the legal requirements in Ohio.
Q: Who needs to fill out Form ODM03197?
A: The abortion provider is responsible for filling out Form ODM03197.
Q: What information is required on Form ODM03197?
A: Form ODM03197 requires information about the patient, the abortion procedure, and the provider.
Q: Is Form ODM03197 confidential?
A: Yes, Form ODM03197 is considered confidential medical information.
Q: What happens with Form ODM03197 after it is filled out?
A: Form ODM03197 is submitted to the Ohio Department of Medicaid for review and compliance purposes.
Q: Are there any fees associated with Form ODM03197?
A: No, there are no fees associated with Form ODM03197.
Q: What are the consequences of not filling out Form ODM03197?
A: Failure to fill out Form ODM03197 may result in legal penalties for the abortion provider.
Q: Can I fill out Form ODM03197 myself?
A: No, Form ODM03197 must be filled out by the abortion provider.
Form Details:
- Released on June 1, 2021;
- The latest edition provided by the Ohio Department of Medicaid;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ODM03197 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
