There is a very strong possibility a patient will have to seek out a new doctor to receive PAS services. In states where physician-assisted suicide is legal, very few doctors actual offer the service. It is estimated that in Oregon, the state where it all started, only 2 -3 % of the physicians offer the service. Most patients seeking physician-assisted suicide usually contact the advocacy group Compassion and Choices to locate a physician. There is also no formal training or medical certification offered to doctors. Those that participate in providing this service usually learn from other doctors who have done it.