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Form PHY-96-2 Certification and Documentation for Abortion - Alabama
What Is Form PHY-96-2?
This is a legal form that was released by the Alabama Medicaid Agency - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form PHY-96-2 Certification and Documentation for Abortion in Alabama?
A: The Form PHY-96-2 is a certification and documentation form required for abortions in Alabama.
Q: Who is required to complete Form PHY-96-2?
A: The physician performing the abortion is responsible for completing Form PHY-96-2.
Q: What information is included in Form PHY-96-2?
A: Form PHY-96-2 includes information about the patient, the physician, the type of abortion procedure, and the medical indication for the abortion.
Q: Is Form PHY-96-2 confidential?
A: Yes, Form PHY-96-2 is confidential and protected by privacy laws.
Q: Are there any penalties for not completing Form PHY-96-2?
A: Failure to complete Form PHY-96-2 can result in disciplinary actions against the physician and may impact the legality of the abortion procedure.
Q: Can I refuse to fill out Form PHY-96-2?
A: As a patient, you cannot refuse to fill out Form PHY-96-2. However, you have the right to ask questions and seek clarification about the form.
Form Details:
- Released on December 7, 2020;
- The latest edition provided by the Alabama Medicaid Agency;
- 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 PHY-96-2 by clicking the link below or browse more documents and templates provided by the Alabama Medicaid Agency.
