Bureau of Public Health Statistics

Abortion Reporting User Registration

You are requesting a user account to access the Arizona Department of Health Services Bureau of Public Health Statistics Abortion Reporting Application.

Step 1:  Select Your Facility.   The Facility will be the name of the facility whose abortion reports you will be submitting.   After selecting your Facility then press the "Continue" button.

If your Facility is not in the selection list press the "My Facility Not Listed" button. Next, please enter your Facility information.

Step 2:  Provide all information requested.   The Email address that you provide must be a vaild Email address where you receive Email.

Step 3:  Submit the registration request.   After your information is validated, you will receive an email to the email address you have provided with further instructions.

Select Facility

Please Select Your Facility

Loading Data Loading Facilities

Enter Facility Information

All fields are required.

Enter User Information

All fields are required.

Request has been accepted

Your request has been accepted.

You will recieve an email to the email address you provided after your account has been activated.

Error Processing Request

Sorry, but your request can not be processed at this time.  If you wish to report this error click "Report Problem".  The error message is below.

Error Processing Request

Password does not match with our records for this user.  Please try again.

Challenge Questions

Please select three challenge questions from the list below.  The selected challenge questions will be used to verify your identity when you request a password reset of your Health Services network login account.  After you have selected the three questions, please press the continue button.

Please provide the answers for the challenge questions from the selection you have made.  After you have provided the answers and an outside DHS email address, please press the complete button.

Must Select Three, (3) Questions Before You Can Continue

Must Provide an Answer For All Three, (3) Questions

Loading Data Loading Password Reset Challenge Questions