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You may download these forms and complete them prior to your appointment:

AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION

AUTORIZACIÓN PARA EL COMPARTIR INFORMACIÓN MEDICA

MEDICATION ABORTION INFORMATION FORM

SURGICAL ABORTION INFORMATION FORM

SURGICAL ABORTION INFORMATION FORM (SPANISH)

 

HIPAA Privacy

You may download these forms and review for privacy information:

NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES

This notice describes how health information about you may be used or disclosed by Planned Parenthood of Greater Ohio and how to access this information.

AVISO SOBRE PRÁCTICAS DE PRIVACIDAD RELACIONADAS CON INFORMACIÓN DE SALUD

Este aviso describe cómo la información relacionada con su salud puede ser usada o divulgada por las oficinas de Planned Parenthood of Greater Ohio y cómo puede usted tener acceso a dicha información por favor, lea este aviso detenidamente.

 

Patient Education Forms

You may download these patient education documents.

Patient Education Form - Directions for Sex Partners: Chlamydia

Patient Education Form - Directions for Sex Partners: Trichomoniasis