(1) Whenever a hospital initially provides medical services to any patient relating to a tumor designated as reportable by ARM 37.8.1801, it must collect, record and make available to the department the following information about that patient:

(a) name and current address of patient;

(b) patient's address at time of diagnosis;

(c) social security number;

(d) name of spouse, if any;

(e) phone number;

(f) race, sex, marital status and religion (optional) ;

(g) age at diagnosis, place of birth and month, day and year of birth;

(h) name, address and phone number of friend or relative to act as contact, plus relationship of that contact to patient;

(i) date and place of initial diagnosis;

(j) primary site of tumor (paired organ) ;

(k) sequence of primary tumors if more than one;

(l) other primary tumors;

(m) method of confirming diagnosis;

(n) histology, including dates, place, histologic type and slide number;

(o) summary staging, including whether in situ, localized, regional, distant or unstaged, with no information;

(p) description of tumor and its spread, if any, including size in centimeters, number of positive nodes, number of nodes examined and site of distant metastases;

(q) whether American joint committee on cancer (AJCC) staging is utilized, and if so, the findings of the staging;

(r) cumulative summary of all therapy directed at the subject tumor, including:

(i) date of therapy;

(ii) specific type of surgery or radiation therapy, if any; and details of chemical, hormonal or other kinds of treatment; and

(iii) if no therapy given, reason for lack of therapy;

(s) status at time of latest recorded information, i.e., whether alive or dead, tumor in evidence or recurring or status unknown;

(t) if recurrence of tumor, type and distant sites of first recurrence;

(u) names of physicians primarily and secondarily responsible for follow up;

(v) date of each follow up; and

(w) if patient has died, date of death, place, cause and whether autopsy performed.