The person who needs to get an abortion consent form signed is the pregnant woman seeking the procedure. In order for the procedure to be legal, she must have the form signed by one parent or legal guardian, as well as a physician.
Name of Doctor/Gynecologist
Doctor/Gynecologist's Phone Number
Reason for abortion.
Please Specify your reason for abortion.
Have you discussed everything regrading your abortion procedure with your gynecologist?
Can you submit all the medical documents supporting your abortion reason.
Do you understand that there are risks associated with having an abortion?
Do you give your consent for abortion?