Book Appointment – Telehealth Abortion

Q1. Are you less than 9 weeks / 63 days pregnant? * Click Here to calculate gestation.

Yes

a. Do you need medications to be delivered to you?

Yes

b. Are you less than 8 weeks 5 days pregnant?

Yes

Q2. Are you above 16 years old? *

Yes

Q3.Do you have access to stable internet that supports video calls? *

Yes

Q4.Do you live within 2hrs drive of the nearest hospital? * For the location of your nearest hospital click here.

Yes

Q5.Will you be travelling to remote location or overseas in the 2 weeks after completing the early medical abortion? *

Yes

Q6. Are you experiencing domestic violence or coercive control? *

Yes

Q7. Are you allergic to Mifepristone or Misoprostol? *

Yes

Q9. Do you have a referral for an ultrasound, blood and urine tests? *

Yes

a. Have you had your ultrasound, blood and urine tests?

Yes

I hereby certify that, to the best of my knowledge, the provided information is true and accurate. *

I consent for this information to be stored as part of my medical records. *

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