Authorized medical facilities must report terminations of pregnancy with the Department of Health and Mental Hygiene (DOHMH).

Authorized medical facilities can request the following termination of pregnancy certificate forms:

  • Induced Termination of Pregnancy Certificates (VR 18)
  • Certificate of Spontaneous Termination of Pregnancy (VR 17)

Requests for the certificate forms will be transferred to (212) 788-4545 (Ext. 46 or Ext. 47). DOHMH will provide instructions to request the certificate forms.

Your order will be completed only if you are authorized to request the forms.

Call 311 for assistance by phone.

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