1. Request An Appointment
2. Complete Patient Intake Forms
3. Information About Your Medical Services

Please REVIEW the REQUIRED Virginia Pre-Information before coming to your appointment. You will be required to acknowledge and certify that you have read the information in advance as per the Virginia Legislature. You will be signing the paperwork at your appointment, but reviewing it beforehand will help to move the process along and minimize the wait time for your procedure.

  • Full Packet [pdf]:  includes:
    • Learn about Abortion Types
      • Medical (Cartoon)
        • Benefits / Risks
        • Aftercare Info
      • Procedural (Dr. F Video TBA) – (by end of July)
        • (Procedural Cartoon to be comissioned) (Fiver)
        • Benefits / Risks
        • Aftercare Info
      • Learn more about — Links – NAF Patient Portal
    • Forms to complete
      • Contact Info / Text / Emergency Contacts
      • Medical Histrory
      • Consent Form
      • Insurance Authorization – Link to Carriers
      • Demographic for VDS
      • HIPAA / Privacy
    • Disclosure of Alternatives, Benefits and Risks of Medical Abortion
    • Consent for Administration of Mifepristone
    • Virginia Pre-Information Confirmation
    • Aftercare at Home (post-Medical Abortion)
    • Insurance Release and Authorization
    • Accepted Insurance
    • Medication Abortion – Full Packet [pdf]:  includes:
      • Information about Medical Abortion
      • Consent to Medical Abortion
      • Disclosure of Alternatives, Benefits and Risks of Medical Abortion
      • Consent for Administration of Mifepristone
      • Virginia Pre-Information Confirmation
      • Aftercare at Home (post-Medical Abortion)
      • Insurance Release and Authorization
      • Accepted Insurance
    • Procedural Abortion – Full Packet [pdf]:  includes:
      • Information about Procedural Abortion
      • Consent to Procedural Abortion
      • Disclosure of Alternatives, Benefits and Risks of Procedural Abortion
      • Anesthesia and Sedation Consent
      • Consent for Administration of Misoprostol
      • Virginia Pre-Information Confirmation
      • Aftercare at Home (post-Procedural Abortion)
      • Insurance Release and Authorization
      • Accepted Insurance

Information for Minors (Under 18)

Are you UNDER 18 and seeking an abortion in the state of Virginia?

 

To view these PDFs you will need ADOBE Acrobat Reader® installed. For a FREE download – click HERE.

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