Administrative Consent Forms:

• HIPAA Privacy Practices Consent (English/Español)

Insurance Information:

• Insurance Release and Authorization (English / Español)
• List of Accepted Insurance Carriers (English / Español)

Medical Service Consent Forms:

• Authorization and Consent for Medical Treatment (English / Español)
• Anesthesia and Sedation Consent (English/Español) (Procedural Abortion Only)

Medical History Forms:

• Medical History Chart  (English / Español)

Patient Information:

• Alternatives, Benefits and Risks of Abortioncare (English / Español)
• Aftercare – Medication (Pill) Abortion (English/Español)
• Aftercare – Procedural Abortion (English/Español)