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Planned Parenthood

Planned Parenthood Center for Choice

Your first visit

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 

 

HIPAA Information 

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




Instructions

 

  • Dress comfortably in a 2-piece outfit with short sleeves. Bring a sweater or jacket; our clinic gets cold.
  • Plan to spend several hours in the clinic.
  • We ask that you NOT bring children with you, due to the length and nature of the visit. If you must bring children , there must be an adult who is responsible for watching them during your entire visit. You cannot leave your children unattended at any time.
  • Everyone, including visitors accompanying patient, must have valid ID to be allowed in the building.
  • Patients must have a valid ID containing their date of birth and an expiration date.
  • Our clinic often has protesters outside. They are opposed to abortion and you do not have to stop for them. It is best to ignore them. We often have clinic escorts there to guide you safely into our clinic. 
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Forms and Instructions