All patients must bring valid, state-issued photo identification with them for each health center visit.

 Additionally, appointments are suggested for all locations and many do not accept walk-up patients. Please call 1-800-230-PLAN to make an appointment.

First visit? Download forms here to save yourself time at the health center.

Thank you for choosing Planned Parenthood Southeast! Upon your first visit to our health centers, you will need to fill out a number of forms to help us to know how best to serve you.

Click the titles below to access the forms as PDF documents, which may require Adobe Acrobat Reader to open and print. The information you provide on these forms is strictly confidential in accordance with our Privacy Policy, available in English and Spanish.

All new patients must submit 3 forms.

  1. Registration Form
  2. Request for Medical Services and Acknowledgement of Privacy Practices
  3. Plus, a medical history. Choose one:

Need to request your medical history? It's easy.

Download this form and send it back to us. We will need to confirm your identity and there may be a small administrative fee.

To Send by mail:
Planned Parenthood Southeast, Inc.
241 Peachtree Street NE
Suite 400
Atlanta, GA 30303
 
To send by fax:
404.688.0621


The information you provide on these forms is strictly confidential in accordance with our Privacy Policy, available in English and Spanish. If you have any questions or concerns, please call 404.688.9300.