Health (Section 335(5)(d) Abortion Notice) Amendment Regulations 2001 (WA)

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WESTERN

AUSTRALIAN

GOVERNMENT

PERTH, MONDAY, 22 OCTOBER 2001 No. 208 SPECIAL

PUBLISHED BY AUTHORITY JOHN A. STRIJK, GOVERNMENT PRINTER AT 3.30 PM

t STATE OF WESTERN AUSTRALIA

Health Act 1911

Health (Section 335(5)(d) Abortion Notice)

Amendment Regulations 2001

Made by the Governor in Executive Council.

1.            Citation

These regulations may be cited as the Health (Section 335(5)(d)
Abortion Notice) Amendment Regulations 2001.

2.             Schedule I amended

Form I in Schedule 1 to the Health (Section 335(5)(d) Abortion Notice) Regulations 1998* is repealed and the following form is inserted instead -

/date of abortion/

FORM I

Health Act 1911

Health ('Section 335(5)(d) Abortion Notice,) Regulations 1998

Notification by Medical Practitioner of Induced Abortion

To Executive Director, Public Health'

Under section 335 (5) (d) of the Health Act /91/ 1...............................................

/please print .full na/nel

provide notice2 of an abortion, which I performed, at'...........................................

faddress where procedure performed/

on....................................................

5630 GOVERNMENT GAZETTE, WA 22 October 2001

1.	Gestational age at date of abortion (best estimate):	weeks
2.	Method of termination: (tick one or more)
Vacuum aspiration (suction curettage)

Dilatation and curettage (sharp)	0
Dilatation and evacuation	0
Vaginal prostaglandin or analogue instillation	0
Other (specify)	0

3.       Reason for termination of pregnancy: (tick one)

Reason other than fetal abnormality	0
Suspected fetal abnormality	0
Actual fetal abnormality	0

specify if known
Selective reduction of multiple pregnancy

4.

Patient's age (last birthday). years

5.       Origin of patient

Aboriginal but not Torres Strait Islander origin	0
Torres Strait Islander but not Aboriginal origin	0
Aboriginal and Torres Strait Islander origin	0
Neither Aboriginal nor Torres Strait Islander origin	0
Not stated	0

6.       Postcode of residence of patient:

Signature

[Signature ofMedical Practitioner]

Executive Director, Public Health, PO Box 8172, Stirling Street, Perth, Perth 6849

2 As required by section 335(5)(d) of the Health Act 1911 notice must be given within 14 days of

the abortion being performed.

Forward completed form (top copy) to Executive Director, Public Heath

Duplicate (yellow copy) to be retained by medical practitioner

[* published in Gazette 5 June 1998, pp. 3048-9.]

By Command of the Governor,

M. C. WAUCHOPE, Clerk of the Executive Council.