Individuals who are 18 years of age or above and have been diagnosed with an unplanned pregnancy can fill the Planned Parenthood Abortion Form.
Name of Doctor/Gynecologist
How long have you been considering abortion?
Why do you feel abortion is the best decision for you at this time?
Reason for abortion.
Please Specify your reason for abortion.
What are your thoughts and feelings about the potential risks and complications of 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 give your consent for abortion?