Medication Abortion Intake

This confidential intake takes about 10–15 minutes. Your progress is saved automatically — you can return and complete it later.

🔒 HIPAA Protected💾 Auto-saved📱 Mobile friendly⏱ ~15 min

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Eligibility Check

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Important: You must be physically located in a covered state both at the time of your visit and when you receive your medication. Your shipping address must also be in a covered state.

What state are you in? *

Date of Birth *

Sex assigned at birth *

Medication abortion services are for patients assigned female at birth. We welcome transgender and non-binary patients.

FemaleMale

🔒 Your information is encrypted and protected under HIPAA.