Form

Abortion notification forms for England and Wales

Guidance and forms (HSA1, HSA2 and HSA4) for recording information about abortions in England and Wales.

Documents

Form HSA1: grounds for carrying out an abortion

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Form HSA1: grounds for carrying out an abortion

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If you use assistive technology (eg a screen reader) and need a version of this document in a more accessible format, please email publications@dh.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Form HSA2: grounds for carrying out an emergency abortion

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Sample form HSA4: abortion notification

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Introduction to completing abortion forms

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Detail

Under the terms of the Abortion Act 1967, as amended by the Human Fertilisation and Embryology 1990, only a registered practitioner can terminate a pregnancy.

Practitioners taking responsibility for the procedure must fill in the notification forms on this page.

Grounds for carrying out an abortion

Form HSA1 and Form HSA2 are paper forms. Form HSA1 is for practitioners to certify their opinion on the grounds for an abortion. Form HSA2 is for emergency abortions.

Informing the Chief Medical Officer of an abortion

Practitioners must notify the Chief Medical Officer of an abortion, using form HSA4. You can:

  • order copies of HSA4 by calling 0300 123 1002
  • fill in the form online

To fill in the form online, you’ll need a password from the Department of Health.

Email: HSA4@dh.gsi.gov.uk

Telephone: 020 7972 5537

As abortion is an emotive subject, and to reduce risk to our staff, we don’t give a named contact.

Guidance on filling in the forms

This page also contains guidance for filling out each of the forms.

Abortion statistics

The Department of Health has a responsibility to monitor the Abortion Act and to publish statistics on abortions in England and Wales. We have processes for checking and monitoring the HSA4 forms that inform statistics.