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Medical Forms

IMPORTANT NOTICE:

If you have scheduled an appointment on November 1, 2023 or after you will need to fill out your forms via the MyChart Patient Portal. Click the link below to learn more. 

If your appointment is on October 31, 2023 or before, please use the eForms instructions further down this page.

If you have questions call us at 941-567-3800.

Patient Portal

Medical Forms

All patients coming in for abortion services must bring a valid photo ID. 

For minors seeking an abortion, please be sure to check with our staff when you make your appointment to ensure that you have all of the necessary forms, such as a copy of your birth certificate, that you will need to complete the parental notification forms.


Transferring or Obtaining Your Medical Records

Planned Parenthood of Southwest and Central Florida requires you to sign a release if you plan to transfer or obtain your medical records. Please allow up to 10 business days to process each paperwork request and keep in mind that fees may apply. To get the appropriate forms, or if you have any additional questions, please contact your local health center.

 

Patient Rights

We take our patients' rights very seriously. Please click below for our Patient Bill of Rights:

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Planned Parenthood cares about your data privacy. We and our third-party vendors, use cookies, pixels, and other tracking technologies to collect, store, monitor, and process certain information about you when you access and use our services, read our emails, or otherwise engage with us. The information collected might relate to you, your preferences, or your device. We use that information to make the site work, analyze performance and traffic on our website, to provide a more personalized web experience, and assist in our marketing efforts. We also share information with our social media, advertising, and analytics partners. You can change your default settings according to your preference. You cannot opt-out of required cookies when utilizing our site; this includes necessary cookies that help our site to function (such as remembering your cookie preference settings). For more information, please see our Privacy Notice.

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