WARNING!

DO NOT ALLOW ANYONE TO PERFORM AN ABORTION ON YOU, WHO REFUSES TO COMPLETE AND SIGN THIS DOCUMENT.

Also, under no circumstances should you allow anyone to take this form away from you, INCLUDING the doctor who is performing your abortion or any member of the clinic or hospital staff. This document may be photocopied if necessary, but in order to protect your legal rights you should keep it in your possession at all times.

Call to schedule your pregnancy confirmation and receive your patient rights.

Click here to view the abortion disclosure form.