You can fill the Planned Parenthood consent form if you are a pregnant woman and want to get an abortion procedure done.
Name of Doctor/Gynecologist
Reason for abortion.
Please Specify your reason for abortion.
How many weeks pregnant are you?
Do you have any medical conditions that we should be aware of?
Have you discussed everything regrading your abortion procedure with your gynecologist?
Is this your first abortion?
Can you submit all the medical documents supporting your abortion reason.
Do you give your consent for abortion?