hospice provider list, and certification form Sec. 6. (a) The state department shall develop a form on which a pregnant woman certifies, at the time of receiving a diagnosis that the pregnant woman's unborn child has a lethal fetal anomaly, that the pregnant woman has received the following: (1) A copy of the perinatal hospice brochure developed under this chapter. (2) A list of the perinatal hospice providers and programs developed under section 5 of this chapter. (b) The provider diagnosing the pregnant woman's unborn child with the lethal fetal anomaly shall, at the time of diagnosis: (1) provide the pregnant woman with a written copy of: (A) the perinatal brochure developed under this chapter; and (B) the certification form developed by the state department under subsection (a); and (2) have the pregnant woman complete the certification form. As added by P.L.213-2016, SEC.12.