CLINICS

DID YOU KNOW?

The birth control pill is one of most effective non-permanent methods of contraception – nearly 100% effective in preventing pregnancy.

Abortion Care Forms

In order to better serve you, we offer most of our information sheets and patient forms online. We do not require that you complete these forms prior to your appointment, however please feel free to do so. If you are still unsure of which abortion method suits your individual needs, please talk to one of our staff, or complete this online workbook: Abortion—Which Method is Right for Me?

Forms required for all abortion procedures:

Additional forms for the abortion pill:

Abortion Pill Information Packet

Baltimore and Twin Cities: 
Medical Abortion Info (Balt and TC) – English
Medication Abortion Info Spanish (Balt and TC)

Texas:

Medical Abortion Info (Texas) – English

Medical Abortion Info – Spanish (Texas)

Medical Abortion Consent

Baltimore and Twin Cities: 

Medical Abortion Consent – English (Baltimore, Twin Cities)

Medication Abortion Take Home – English (Baltimore, Twin Cities)

Texas:

Medication Abortion Consent – Texas (English)

Take-Home Instructions
Medication Abortion Take Home (Texas) – English
Medication Abortion Take Home (Texas) – Spanish

At Home Symptom Diary
At Home Symptom Diary (English)

Additional forms for early surgical abortion:

Additional forms for second trimester abortion:


Additional forms for minors (under age 18) seeking an abortion

In Texas, state law requires a parent consent to an abortion procedure for their child, if the child is under 18. The form below must be signed by the parent and child, and the parent’s signature must be notarized by a notary public. We offer a notary public at our clinic free of charge, for parents who wish to sign the consent here on the day of the abortion.

Patient rights and responsibilities form

(Required for patients seeking second trimester abortion care)

patient rights and responsibilities (English)


WWH

Blog



THANK YOU.


Read more......


WHOLE WOMAN'S
HEALTH:
INTERNATIONAL
WOMEN'S DAY


Read more......



WHOLE WOMAN'S
HEALTH: TEXAS POLICY
EVALUATION PROJECT
BRIEFING COVERAGE


Read more......