Get FL Abortion Certification Form 2001-2021
________ 3. Medicaid Identification Number:__________________________________________ SECTION II 4. On the basis of my professional judgment, I have performed an abortion on the above named recipient for the following reason: The woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused or arising from the pregnancy itself that would place the woman in danger of death unless an abortion is performed. Based on all the inf.
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