Medical Forms
IMPORTANT NOTICE:
If you have scheduled an appointment on November 1, 2023 or after you will need to fill out your forms via the MyChart Patient Portal. Click the link below to learn more.
If your appointment is on October 31, 2023 or before, please use the eForms instructions further down this page.
If you have questions call us at 941-567-3800.
Save Time with eForms
You can complete your medical questionnaire before your appointment.
No registration is required. When you have completed the form, please be sure to submit the information so that it will be sent to our staff.
Medical Forms
All patients coming in for abortion services must bring a valid photo ID.
For minors seeking an abortion, please be sure to check with our staff when you make your appointment to ensure that you have all of the necessary forms, such as a copy of your birth certificate, that you will need to complete the parental notification forms.
Transferring or Obtaining Your Medical Records
Planned Parenthood of Southwest and Central Florida requires you to sign a release if you plan to transfer or obtain your medical records. Please allow up to 10 business days to process each paperwork request and keep in mind that fees may apply. To get the appropriate forms, or if you have any additional questions, please contact your local health center.
Patient Rights
We take our patients' rights very seriously. Please click below for our Patient Bill of Rights: