Schedule Your First Appointment

Things to know about your first appointment with us:

• Under Ohio law, our clinic is not allowed to perform an abortion if WE KNOW that any part of your reason is based on the fact that the fetus has Down Syndrome or the possibility that the fetus may have Down Syndrome. If we learn that any part of your reason has to do with Down Syndrome, then our clinic cannot provide your abortion. (This applies only to Down Syndrome and not any other condition.)

Please note: our waiting room area is only large enough to accommodate patients.  During your visit, you can include your support person via your cell phone or other electronic device with the following exceptions:

• Patient is a minor.
• Patient is disabled.
• A photo ID (must have your picture, name, and date of birth listed)
• A $150 non-refundable fee will go towards your procedure balance.
•  We accept Money orders, Debit cards, MasterCard, Visa, and Discover. We accept HSA cards as long as they are underwritten by MasterCard or Visa.
• Parents/guardians of minors must have a photo ID (for themselves) and a birth certificate for the patient.
• If you are a minor and believe the previous requirement is impossible, please call us for information regarding a “Judicial Bypass”.

• 

  You can not schedule a second appointment on this page

   

  Patient's First Name as it appears on your photo ID *

  Patient's Last Name as it appears on your photo ID *

  Phone Number *

  Email *

  Have you taken a pregnancy test? *

  Yes

  No

  Can we identify ourselves as Northeast Ohio Women's Center if we need to call or text? *

  Yes

  No

  Age *

  Are you a returning patient? *

  Yes

  No

  Read carefully

  Last NORMAL menstrual period? (You will NOT be scheduled if it has NOT been at least 5 WEEKS since the FIRST day of your last NORMAL menstrual period.) *

  Are you interested in a 2 Day Visit (CUYAHOGA FALLS LOCATIO or SHAKER HIGHTS))

  Yes

  No

  Are you interested in Same Day Surgical Proceedure (CUYAHOGA FALLS LOCATION ONLY)

  Yes

  No

  Are you interested in Same Day Abortion Pills (CUYAHOGA FALLS & SHAKER HIGHTS LOCATIONS)

  Yes

  No

  *

  If you need to apply for FUNDING (*The links are on The “WELCOME” Page) you will be contacted by them usually within 24 hours. After being contacted, you can then request an appointment below but NOT BEFORE!

  Cuyahoga Falls on WEDNESDAY 10/23, THE CLINIC HOURS Are: 10:00am - 1:00pm, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Cuyahoga Falls on THURSDAY 10/24, THE CLINIC HOURS Are: 9:00am - 12:00pm, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Cuyahoga Falls on FRIDAY 10/25, THE CLINIC HOURS Are: 11:00am - 2:00pm, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Cuyahoga Falls on SATURDAY 10/26, THE CLINIC HOURS Are: 8:00am - 11:00am, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Shaker Heights on TUESDAY 10/22, THE CLINIC HOURS Are: 4:00pm - 6:00pm, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Shaker Heights on THURSDAY 10/24, THE CLINIC HOURS Are: 4:00pm - 6:00pm, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Shaker Heights on SUNDAY 10/27, THE CLINIC HOURS Are: 9:30am - 11:30am, We WILL SEND AN EMAIL, YOU MUST ANSWER IT.

  Additional Notes:

  By submitting this online form, you consent to receiving electronic communication from us (via email). 

  PLEASE MAKE SURE TO PROVIDE A  SAFE AND SECURE EMAIL ADDRESS THAT YOU FEEL COMFORTABLE RECEIVING UPCOMING APPOINTMENT INFORMATION.

  

  If you are human, leave this field blank.