The state registrar shall prescribe forms for the collection of information and statistics with respect to enforceable gestational carrier contracts. Such forms shall require but not be limited to the following information:

            (1) The age, marital status, and state and parish of domicile of the gestational carrier.

            (2) The parish in which the in utero embryo transfer took place.

            (3) The full name and address of the physician or physicians performing or attending to the following phases of the gestational carrier:

            (a) In utero embryo transfer.

            (b) Prenatal and postnatal care.

            (c) Birth.

            (d) Miscarriage.

            (e) Induced abortion.

            (4) The age, marital status, and state and parish of domicile of the intended parents.

            (5) The medical reason necessitating the gestational carrier.

            (6) The medical procedures employed in the birth, miscarriage, or termination of pregnancy for medical emergency as provided by La. Rev. Stat. 40:1061.23.

            (7) The length and weight of the child born as a result of gestational carrier.

            (8) The length and weight of an unborn child miscarried after the initiation of a gestational carrier.

            (9) Other significant conditions or health complications of the unborn child and gestational carrier.

            (10) The results of pathological examinations of any unborn child who died as a result of pregnancy complications or termination incidental to a gestational carrier.

            Acts 2016, No. 494, §4.