other providers Sec. 5.1. Each form or other written document that must be completed or provided by a physician or other provider under this chapter, including a signed copy retained in the pregnant woman's patient file, must include the following: (1) A line for the signature of the physician or other provider. (2) A line for the professional credentials and license number of the physician or other provider. As added by P.L.213-2016, SEC.17.