Request for Medical Records
To request your medical records sent from another medical provider to Planned Parenthood, complete the provider information and send in this form.
To request Planned Parenthood to send your medical records to another provider, complete this form.
You can fill out your demographic data and medical history prior to your appointment. Just remember to bring the forms with you to your appointment, along with photo identification.
Reproductive Health Services
Complete and fax Medical History Form to 314-531-9730 prior to physician consultation.
Special Instructions for patients on procedure day.
Visit one of our six health centers or call 800.230.7526 to schedule your appointment.
