Jack Plagge, Manager
Hospital & Outpatient Services Unit
Bureau of Health Facility Regulation
2727 Mahan Drive, Mail Stop #31
Tallahassee, Florida 32308
Telephone: (850) 412-4549
Florida Relay Service (TDD): (800) 955-8771
Fax: (850) 488-5897
An abortion clinic is a licensed facility for the termination of pregnancy. This does not include a hospital or a physician's office where abortions are performed but not used primarily for the performance of pregnancy terminations.
Renew Online – Providers can now renew their licenses through the Agency’s Online Licensing application.
Facilities must meet license requirements through the submission of a completed application, required documentation, and completion of a satisfactory survey.
This includes new facilities and reactivation of an expired license. At least 60 days before the effective date, an applicant must submit a licensure application, fees and supporting documents. When all required information is received and acceptable, licensure and life safety surveys will be scheduled. A license will be issued when documentation of successful licensure and life safety surveys are complete and filed. Note: A valid license is required before services can be provided.
The licensure application, renewal fee and supporting documents must be submitted to the Agency 120 to 60 days prior to the expiration date. A late fee of $50 per day, up to 50% of the licensure fee or $500 (whichever is less) will be assessed for any application not received 60 days prior to expiration. A renewal application will not be accepted if the license is expired. An initial license application must be filed if the license has expired. Renew Online – Providers can now renew their licenses through the Agency’s Online Licensing application.
Chapter 408.803, Florida Statutes defines "Change of ownership" as: an event in which 51 percent or more of the ownership, shares, membership, or controlling interest of a licensee is in any manner transferred or otherwise assigned. This does not apply to a licensee that is publicly traded on a recognized stock exchange. Also, a change solely in the management company or board of directors is not a change of ownership.The licensure application, fee and supporting documents (see application checklist) must be submitted at least 60 days prior to the change of ownership. Before the application can be approved, any outstanding fees owed the State (owed by either party) must be paid and a bill of sale or other closing document signed by the buyer and the seller and showing the effective date of the transfer must be received by the Agency.
A change of physical address requires submission of an application and the $25 change fee. Other documents that may be required include AHCA Form 3100-0007 and documentation verifying the applicant’s right to occupy the premises at the new address (i.e. warranty or quit claim deed; lease or rental agreement).
A change in services provided requires submission of an application and the $25 change fee. If the clinic is adding services not currently provided, a license authorizing the additional services will be issued when documentation of a successful licensure survey is completed. Please note a valid license is required before the additional services can be provided.
A licensee must inform the agency not less than 30 days prior to the discontinuance of operation and comply with the requirements listed in Chapter 408.810(4), F.S.
|AHCA Form 3130-1000||All application types||Standard abortion clinic application required to apply for or modify an abortion clinic license.|
|AHCA Form 3130-1000CL||
Application Checklist Abortion Clinic [53KB, DOCX]
|A checklist for assistance in completing the Health Care Licensing Application for abortion clinics.|
|AHCA Form 3110-1024||
Application Addendum [126KB, DOC]
|Please provide this information to comply with the reporting requirements of Chapter 408, Part 11, Florida Statutes. Use of the form is not required if the same information is provided by other means.|
|AHCA Form 3170-2004||
|Clinical laboratory licenses under the same ownership/control as the abortion clinic must concurrently submit a clinical laboratory application.|
|Articles of Incorporation or similarly titled document as filed with the Florida Department State.|
|Proof of Right to Occupy Premises||Initial
Change of Address
|Any documentation verifying the applicant’s right to occupy the premises at the physical address of the clinic (i.e. warrant or quit claim deed; lease or rental agreement).|
|Compliance With Zoning Requirements||Initial
Change of Address
|Any documentation from a local government identifying the facility is in compliance with local zoning requirements.|
|Certificate of Occupancy||
Initial due to new construction.
Change of address due to new construction.
Specific documentation from a local government granting the right to occupy a facility.
|Contract between the owner and a management company for management of services.|
|Closing Document||CHOW||Bill of sale or similar document signed by the buyer and the seller indicating the date of transfer of ownership.|
|Statement of Outstanding Deficiencies||CHOW||Statement from the buyer assuring any uncorrected licensure survey deficiencies will be corrected timely.|
|Statement of Outstanding Payments||CHOW||Statement from the buyer identifying any outstanding balance owed AHCA, and indicating who will pay and when.|
|AHCA Form 3130-1003||
Abortion Clinic Incident Reporting Form [74KB, DOCX]
|Reporting||This form is to be completed and sent to the Agency within 10 calendar days of an adverse incident.|
|AHCA Form 3130-1002||Patient's medical record||This form should be used to document a patient's refusal to permit administration of Rho(D) Immune Globulin.|
Chapter 390.0112, Florida Statutes, requires the director of any medical facility in which abortions are performed, including a physician's office, to
submit a monthly report to the Agency.
The report must be submitted electronically to the Agency pursuant to Rule 59A-9.034, F.A.C. within 30 days following the end of each month and shall include information consistent with the United States Standard Report of Induced Termination of Pregnancy adopted by the Centers for Disease Control and Prevention. Abortion clinics must submit a report for each month that the clinic is licensed, even if no pregnancies were terminated during the reporting period. The statute permits a $200 fine to be imposed if reports are not submitted timely.
Links to the Induced Termination of Pregnancy (ITOP) reporting system, reporting guide, and related questions & answers are below:
ITOP Monthly Reporting System via the AHCA Portal login - January 1, 2017
ITOP Reporting System Guide - January 1, 2017 [3 MB, PDF]
Registration Questions and Answers [930 KB, PDF]
Florida Statute requires that individual monthly reports are confidential and are not permitted to be released to anyone except upon court order in a civil or criminal proceeding. Summaries of the reported data are available at http://ahca.myflorida.com/MCHQ/Central_Services/Training_Support/Reports.shtml.
A level 2 background screen is required of the administrator responsible for the day to day operations of the facility and the chief financial officer. Please visit the Agency's background screening web page for additional information regarding vendors, fees, locations etc. Background screens must be repeated every 5 years.