Online Forms

We know you've got a crazy schedule. This might save some time at your next visit!

Any visit for a physical examination requires a complete patient registration form and patient history form. These forms, along with some additional forms that may be helpful or required for your upcoming visit, are listed below. For your convenience, you can print and fill out these online forms beforehand and bring them with you to your appointment.

Did you know we offer same-day appointments and have extended hours? Find your nearest Planned Parenthood and schedule your next appointment online—or call us at 1-800-230-PLAN.

Patient Registration Form

Download and print our Patient Registration Form. Please handwrite in black ink. If you have any questions, we're here to help.

English language
Patient Registration Form (PDF)

Spanish language
Registro de Paciente (PDF)

Any visit for a physical examination requires a complete Patient Registration Form and Patient History Form.

Obtaining Government-issued Identification

Please bring a valid form of identification with you to your procedure. The following are instructions on obtaining state-issued identification and a list of other approved forms of identification that you can bring with you to your appointment.

English
Obtaining Government-issued Identification (PDF)

Spanish
Cómo Obtener una Identificación Emitida por el Gobierno

Parental and Minor Consent Forms and Facts

Please visit the Info for teens and parents page for complete information and forms.

Protected Health Information

Request for Access to Health Information (PDF)

Solicitud de Acceso a Información Médica (PDF)

Please handwrite in black ink. If you have any questions, we're here to help.

Hormone Therapy History Forms

PP Direct - Telemedicine

Notice of Health Information Privacy Practices