Planned Parenthood

Planned Parenthood Center for Choice

Forms and Instructions

Forms for Your Visit

You can save time by completing the following forms (PDF) and presenting them at the time of your visit.  (Please use a black ink pen)


Initial Visit Health History 

(Para imprimir esta forma en español, de click aquí)


Welcome to Planned Parenthood Information


Consent form 

(to be notarized for teens)


HIPAA Information 

(It is not required that you print this form. It is for your information only.)
Lea este documento en español.

Pre-Abortion Instructions

1) Starting 2 hours before your appointment, DO NOT EAT OR DRINK ANYTHING.

2) It is very important that you avoid using any alcohol after midnight the night before your appointment.  If you are on prescription medications, contact the clinic and discuss these medications with the nurse (unless you have already received instructions about your medications).

3) Please wear loose, comfortable clothing.

4) You can expect to be at Planned Parenthood for 3-5 hours.


Procedure and Sedation 


You should expect to spend a total of 3-5 hours in the clinic on the day of the procedure. You will be asked to complete a medical history and meet with a trained counselor. This counselor will be able to answer any questions you may have about the procedure, as well as questions about birth control. There will also be various consent forms for you to sign, and the counselor will help to explain them. The counselor is there to help you with fears or doubts you may be having as well as answering the questions you have. A pelvic exam will be performed, and will be asked to provide a urine and blood sample. These samples will be used to confirm your pregnancy, determine your blood type, and to check for anemia. In addition, an ultrasound will also be performed to determine how far along the pregnancy is. A small cervical dilator may need to be inserted the day before your procedure if it has been more than 11 weeks since your last menstrual period, the doctor may need to do a minor procedure to stretch your cervix (opening to the womb) before you have the abortion done.

Intravenous sedation and local anesthesia are available for your comfort during the procedure. You may want to discuss these options with the counselor. The effects of sedation may last for several hours, so you must make arrangements to have someone drive you home.

After the abortion procedure, a stay in the recovery room includes blood pressure checks, a brief rest, and a small snack. You will need to have a check-up in about three weeks at any Planned Parenthood Health Center, or with your private physician.


Post Abortion Instructions

Please take a look at our form with after-care instructions, we have it available in EnglishSpanish, and Vietnamese.

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Forms and Instructions