Request An Appointment aborto North Florida Women's Services

To make an appointment for an abortion, please fill out the following form.

NOTE: The state of Florida has a 24 hour waiting period between the time of consent with the doctor and the abortion procedure. All procedures require 2 visits to our office. — we’re sorry for the inconvenience.

After we receive your online appointment request we will call as quickly as possible, if it’s after business hours, we’ll call first thing early next morning.

Make sure you provide a number where you can receive calls — we WILL call you at the telephone number. If we don’t reach you, we will leave a discrete message.

Pick a day and time for your appointment while talking with the staff. They will also explain the office policies and what to expect.

We DO NOT offer procedures or follow-up appointments on the weekends.
Staff on call for urgent concerns 24/7, but you must leave a voicemail to receive a call back.

Request An Appointment

Today's Date*
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Patient's Name*
First Last
Date of Birth*
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City of Residence*
City
Telephone Number*
Email*
Date of Last Normal Period*
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4 digit pin to be used as an identifier for confidentiality purposes*
Create your own 4 digit pin that will be used for all phone conversations to ensure patient confidentiality.
Comments or Concerns
How did you hear about us?*
- Abortion Clinics Online Directory
- Google / Bing Search
- Family Member / Friend
- Private Doctor
Protection against automated spam

Confidentiality Notice

Your information will be transmitted by secured, encrypted e-mail. Though we make every effort to keep your information secure, it is still possible that the information you provide could be captured by individuals who are engaged in illegal internet observance. By providing and submitting your confidential information, you accept the risk of sending this information by e-mail to North Florida Women’s Services personnel and agree not to hold the center or its employees liable for any damages you may incur as a result of the transfer or use of this information.

Beware of Crisis Pregnancy Centers they do not support a woman’s right to choose.