This online form is for your DAY 1 ABORTION CONSULTATION ONLY. If you are trying to schedule a PAP Exam or any other kind of appointment, please call our office at 614-251-1800.

There are only 2 abortion clinics serving the central ohio area. in order to meet this demand, we ask that our patients plan to be here for 2-3 hours during your first visit.

PLEASE READ BEFORE SCHEDULING YOUR FIRST APPOINTMENT:

ARRIVAL: Please arrive at the time you were scheduled. Arriving early will not expedite the process.
COST: An initial consultation is $100.00 (which will go towards the cost of your abortion at our facility). This fee is non-refundable and must be paid when you arrive. We accept cash, credit card, debit card or money order. We do not accept checks. Credit cards are only accepted with cardholder present.
GUESTS: You may bring one support person, but only the patient is allowed beyond the lobby. Please let your support person know that we do not have a public restroom and they will not be with you during your consultation. No children are allowed.
IDENTIFICATION: Please bring your Driver’s License or State Picture ID with you.
PARKING: There is a parking lot in the back of the building, or you can park on Broad Street or Sherman Avenue.
MINORS: If you are under 18, you must bring your birth certificate and a photo ID. Your parent or guardian must also bring their Driver’s License or State Picture ID with them. Your parent or guardian does not have to stay for the entire visit.
INTERPRETER: If you have a language barrier, you are required to bring a female interpreter with you to your first visit. Male interpreters are not allowed.

please fill out the form below and click the "Submit" button.

Note: Before clicking the "Submit" button, please write your appointment time down, as we do not send confirmation emails. We also do not confirm appointments over the phone due to patient confidentiality.

Name *

Name

First Name

Last Name

Phone Number

(###)

###

####

If you are less than 18 years old, a parent or guardian must come with you for the 1st appointment. If this is not possible, Ohio law requires that you obtain a "judicial bypass." Also, don't forget to bring your birth certificate with you to your 1st appointment.

Age *

First day of your last menstrual period:

YYYY

Have you had a positive pregnancy test? *

Yes

Are you a previous patient? *

Yes

If you answered YES, please enter your date of birth.

YYYY

Choose your first appointment date & time: *

Appointment dates are updated on a weekly basis. If you would like to schedule your appointment more than a week out, you will need to schedule by phone.