Want to save some time during your appointment?
You can speed up your visit by completing the necessary forms below and bringing them to your appointment. Please note: You only need to complete the funding application if you are applying for financial assistance.
If you have questions or need help, call 1-800-230-PLAN.
If you are applying for low or no-cost services, please complete the funding application and bring it with you to your Planned Parenthood appointment.
Medical Records Release to a Third Party
Need your medical information to go to another medical provider or another third party? Print and complete this form, then fax it or take it to the Planned Parenthood clinic where your records are. If you're simply switching from one Planned Parenthood clinic in Minnesota or South Dakota to another Planned Parenthood clinic in the same area, you don't need this form.
Medical Records Release
Do you want a copy of your medical records for your personal records? Print and complete this form, then fax it or take it to the Planned Parenthood clinic where your records are.
We understand that you might prefer to be contacted using your personal e-mail address. Planned Parenthood Minnesota, North Dakota, South Dakota (PPMNS) will use the e-mail address you provide us to send you communications about non-urgent, non-sensitive matters.