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California Business And Professions Code BPC Section 804

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(a) Any agency to whom reports are to be sent under Section
801, 801.1, 802, or 803, may develop a prescribed form for the making
of the reports, usage of which it may, but need not, by regulation,
require in all cases.
   (b) A report required to be made by Sections 801, 801.1, or 802
shall be deemed complete only if it includes the following
information: (1) the name and last known business and residential
addresses of every plaintiff or claimant involved in the matter,
whether or not each plaintiff or claimant recovered anything; (2) the
name and last known business and residential addresses of every
physician or provider of health care services who was claimed or
alleged to have acted improperly, whether or not that person was a
named defendant and whether or not any recovery or judgment was had
against that person; (3) the name, address, and principal place of
business of every insurer providing professional liability insurance
as to any person named in (2), and the insured's policy number; (4)
the name of the court in which the action or any part of the action
was filed along with the date of filing and docket number of each
action; (5) a brief description or summary of the facts upon which
each claim, charge or judgment rested including the date of
occurrence; (6) the names and last known business and residential
addresses of every person who acted as counsel for any party in the
litigation or negotiations, along with an identification of the party
whom said person represented; (7) the date and amount of final
judgment or settlement; and (8) any other information the agency to
whom the reports are to be sent may, by regulation, require.
   (c) Every person named in the report, who is notified by the board
within 60 days of the filing of the report, shall maintain for the
period of three years from the filing of the report any records he or
she has as to the matter in question and shall make those available
upon request to the agency with which the report was filed.


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Last modified: April 11, 2008