Okla. Stat. tit. 63, § 63-1-738l

A. Complications of Induced Abortion Report. By March 1, 2012,

the State Department of Health shall prepare and make available, on

its stable Internet website, a Complications of Induced Abortion

Report for all physicians licensed and practicing in the State of

Oklahoma.

B. Subsection C of this section shall become operative on the

later of:

1. April 1, 2012; or

2. Thirty (30) calendar days following the date on which the

State Department of Health posts on its stable Internet website the

Individual Abortion Form and instructions concerning its electronic

submission referenced in Section 3 of this act.

C. Any physician practicing in Oklahoma who encounters an

illness or injury that a reasonably knowledgeable physician would

judge is related to an induced abortion shall complete and submit,

electronically or by regular mail, a Complications of Induced

Abortion Report to the Department as soon as is practicable after

the encounter with the induced-abortion-related illness or injury,

but in no case more than sixty (60) days after such an encounter.

Nothing in the Complications of Induced Abortion Report shall

contain the name, address, hometown, county of residence, or any

other information specifically identifying any patient. Knowing or

reckless unreasonable delay or failure to submit a Complications of

Induced Abortion Report shall be sanctioned according to the

provisions of the Statistical Abortion Reporting Act.

Oklahoma Statutes - Title 63. Public Health and Safety Page 353

D. The Complications of Induced Abortion Report shall contain a

notice containing an assurance that in accordance with subsection F

of Section 5 of this act, public reports based on the form submitted

will not contain the name, address, hometown, county of residence,

or any other identifying information of any individual female, that

the State Department of Health will take care to ensure that none of

the information included in its public reports could reasonably lead

to the identification of any individual female about whom

information is reported in accordance with the Statistical Abortion

Reporting Act, or of any physician providing information in

accordance with the Statistical Abortion Reporting Act, and that

such information is not subject to the Oklahoma Open Records Act.

E. Complication(s) of Induced Abortion Report. The

Complications of Induced Abortion Report shall be substantially

similar to, but need not be in the specific format of, the following

form:

Complications of Induced Abortion Report

1. Name and specialty field of medical practice of the

physician filing the report: _________________________________

2. Did the physician filing the report perform or induce the

abortion? ________________________________________________

3. Name, address, and telephone number of the health care

facility where the induced abortion complication was discovered or

treated: __________________________________________________________

4. Date on which the complication was discovered: ________

5. Date on which, and location of the facility where, the

abortion was performed, if known: _________________________________

6. Age of the patient experiencing the complication: _____

7. Describe the complication(s) resulting from the induced

abortion: ______________________________________________________

8. Circle all that apply:

a. Death

b. Cervical laceration requiring suture or repair

c. Heavy bleeding/hemorrhage with estimated blood loss of

greater than or equal to 500cc

d. Uterine Perforation

e. Infection

f. Failed termination of pregnancy (continued viable

pregnancy)

g. Incomplete termination of pregnancy (Retained parts of

fetus requiring re-evacuation)

h. Other (May include psychological complications, future

reproductive complications, or other illnesses or

injuries that in the physician’s medical judgment

occurred as a result of an induced abortion. Specify
ne Perforation

e. Infection

f. Failed termination of pregnancy (continued viable

pregnancy)

g. Incomplete termination of pregnancy (Retained parts of

fetus requiring re-evacuation)

h. Other (May include psychological complications, future

reproductive complications, or other illnesses or

injuries that in the physician’s medical judgment

occurred as a result of an induced abortion. Specify

diagnosis.): _______________________________

Oklahoma Statutes - Title 63. Public Health and Safety Page 354

9. Type of follow-up care, if any, recommended:

______________________

10. Will the physician filing the Complications of Induced

Abortion Report be providing such follow-up care (if not, the name

of the medical professional who will, if known)?

_____________________________

11. Name and license number of physician filing the

Complications of Induced Abortion Report: _________________________