Schedule Your First Appointment

Things to know about your first appointment with us:

Your first appointment is for CONSULTATION ONLY — no abortion procedure (including the abortion pill) can happen on the day of the consultation per Ohio state law.

THIS APPOINTMENT FORM IS NOT TO SCHEDULE PROCEDURES

• A photo ID (must have your picture and date of birth listed)
• A $100 non-refundable fee that will go towards your procedure balance (cash, credit card, or money order).
• We accept MasterCard, Visa and Discover. We accept HSA cards as long as they are underwritten by MasterCard or Visa.
• NOTE: The cardholder needs to be present or available by phone to authorize the payment.
• If you are a minor, you MUST bring a photo ID and a legal guardian/parent with you for your first appointment.  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 impossible, please call us for information regarding a “Judicial Bypass”.
• If you have questions about this policy, please call us,

On-Line Web appointment times:

• Look below for available times.  Other times may be available. Please call 330-923-4009.

First Name *

Last Name Initial (one letter) *

Phone Number *

Email Address *

If you're a minor (under the age of 18), a parent or guardian must sign a written consent at your first appointment. If this is impossible, we will talk to you about a "court bypass" for this part of Ohio law

Age *

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

Yes

No

Have you taken a pregnancy test? *

Yes

No

Last normal menstrual period: *

Are you a returning patient?

Yes

No

Limited funding is now available from the NAF (National Abortion Federation). Are you interested in seeking partial funding?

Yes

No

Two locations to choose from: Cuyahoga Falls OR Shaker Heights

You may select your first appointment in any ONE of those locations below.

Additional Notes:

This email will be from: schedulingneowc2127@gmail.com
Please review as important details will be included.

Select your appointment date and location.

Cuyahoga Falls Wednesday, 1/20: Our office hours are 10:00 - 2:00 - A confirming email to follow with YOUR appointment time.

Cuyahoga Falls Thursday, 1/21: Our office hours are 11:00 - 3:00 - A confirming email to follow with YOUR appointment time.

Cuyahoga Falls Friday. 1/22: Our office hours are 9:30 - 1:00 - A confirming email to follow with YOUR appointment time.

Cuyahoga Falls Saturday. 1/23: Our office hours are 8:00 - 12:00 - A confirming email to follow with YOUR appointment time.

Cuyahoga Falls Monday, 1/25: Our office hours are 11:00 - 3:00 - A confirming email to follow with YOUR appointment time.

__________________________________________________

Shaker Heights Tuesday, 1/19: Our office hours are 2:00 - 5:00 - A confirming email to follow with YOUR appointment time.

Shaker Heights Thursday, 1/21: Our office hours are 4:30 - 7:00 - A confirming email to follow with YOUR appointment time.

Shaker Heights Friday. 1/22: Our office hours are 2:00 - 4:30 - A confirming email to follow with YOUR appointment time.

Shaker Heights Sunday, 1/24: Our office hours are10:00 - 1:00 - A confirming email to follow with YOUR appointment time.

Shaker Heights Tuesday, 1/26: Our office hours are 2:00 - 5:00 - A confirming email to follow with YOUR appointment time.

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