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.

Please note: 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.) 

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 (credit card, or money order – Cash is NOT accepted).
• We accept MasterCard, Visa and Discover. We accept HSA cards as long as they are underwritten by MasterCard or Visa.
• 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.

Last Name *

First Name *

Phone Number *

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

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

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

Yes

No

Email Address *

Age *

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.

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

I’m interested in more information about a Day 2 Visit via Zoom

YES

Select your appointment date and location.

Cuyahoga Falls Thursday, 12/9 Our office hours are 11:00 - 3:00 - An email will follow with YOUR appointment time.

Cuyahoga Falls Friday, 12/10: Our office hours are 9:00 - 1:00 - An email will follow with YOUR appointment time.

Cuyahoga Falls Saturday, 12/11: Our office hours are 8:00 - 12:00 - An email will follow with YOUR appointment time.

Cuyahoga Falls Monday, 12/13: Our office hours are 8:00 - 11:30 - An email will follow with YOUR appointment time.

Cuyahoga Falls Tuesday, 12/14: Our office hours are 1:00 - 4:00 - An email will follow with YOUR appointment time.

Cuyahoga Falls Wednesday, 12/15: Our office hours are 10:00 - 2:00 - An email will follow with YOUR appointment time.

-------------------------------------

Shaker Heights Tuesday, 12/7: Our office hours are 9:00 - 12:00 - An email will follow with YOUR appointment time.

Shaker Heights Thursday, 12/9: Our office hours are 4:30 - 7:00 - An email will follow with YOUR appointment time.

Shaker Heights Friday, 12/10: Our office hours are 2:30 - 5:00 - An email will follow with YOUR appointment time.

Shaker Heights Sunday, 12/12: Our office hours are 10:00 - 1:00 - An email will follow with YOUR appointment time.

Shaker Heights Tuesday, 12/13: Our office hours are 9:00 - 12:00 - An email will follow with YOUR appointment time.

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.) You must confirm your understanding by checking the box below. *

I understand. This does not apply to me.

Additional Notes:

If you do not receive your appointment confirmation message within 48 hours, please check your Spam or Bulk E-Mail folder just in case the confirmation email got delivered there instead of your inbox. If so, select the confirmation message and mark it Not Spam, which should allow future messages to get through.

If you are human, leave this field blank.