Request for Medical Records
To transfer your records from PPGNY to another health facility, please fill out this form and mail or bring it to PPGNY.
Patient Bill of Rights
Read PPGNY's Patient Bill of Rights in English and Spanish to find out about your legal rights as patients.
Financial Assessment and Patient Contact Form
Family Planning Benefit Program Application Instructions
Family Planning Benefit Program Application
Surgical Abortion with Moderate or Deep Sedation (in Manhattan)
Surgical Abortion with Local Sedation (in Manhattan)
Surgical Abortion with Minimal Sedation (in Manhattan, Brooklyn, Bronx, or Queens)
Surgical Abortion with Local Sedation (in Brooklyn, Bronx, or Queens)
Or call 1-800-230-7526