If you need to transfer or obtain your medical records, you will need to sign a release if you would like:
- To send your medical records to another provider - upload the PDF version HERE.
- A copy of your medical records sent directly to Planned Parenthood - upload the PDF version HERE.
Please allow up to 10 business days to process your request. Fees may apply.
Please call your local health center to find out more or if you have any questions!
Annual/Initial Visit Paperwork
Medical History Form - in English
Consent for Medical Services - in English - in Spanish
HOPE Visit Paperwork (obtain Birth Control without exam if you qualify):
Brief Contraception History Form - in English - in Spanish
Consent for Medical Services - in English - in Spanish
Limited Service Paperwork (STI check, Infection check, etc.)
Limited Service History Form - in English
Consent for Medical Services - in English - in Spanish
Abortion Services Paperwork
Medical History form for an Abortion appointment -in English
