Medication Abortion Booking Form – Willow Clinic

Medication Abortion Booking Form

Before filling out the booking form:

  • Make sure you have  read about Medication Abortions here.
  • Make sure you have had a positive pregnancy test from either an at home pregnancy test or from a health care provider 
  • We will also need the first date of your last period (if you know it)
  • You will need to be 10 weeks or less from the first day of your last period on the day on the day that we are able to see you
  • Referral from a doctor is welcome but not required. If you would like we can send a letter to your doctor about your visit.
  • Please make sure to have your BC medical number (PHN) with you if you have one.

We usually book appointments within a few days, so we will do our best to respond promptly.

  • Make sure you can spend 5 to 10 minutes on the phone when booking your appointment or when we call you back. We will be asking you some personal questions and giving you some more information so you may need some privacy for this call.
  • If you require an interpreter, please let us know and we can assist with telephone interpretation services.

We will try to contact you at least 3 times throughout the next business day. ( Mon – Fri )
If we do not reach you please try and call us at: Telephone hours: 9:30 – 12:00 and 1:30 – 4:30, Monday – Friday. Call 604-709-5611

Once you are ready you can call us or fill out the call request form :

 

Please enable JavaScript in your browser to complete this form.
Yes or No? - If not, please READ it Prior to Booking an Appointment.
Type your name above
Please enter the # with HYPHENS or spaces between your Digits, Eg. 604 - 233 - 8647 - Thank you
Day - Month

You may also be asked to refer to these forms:

DO NOT FILL THE FOLLOWING FORM UNLESS ASKED BY OUR STAFF:

 

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Willow Reproductive Health Centre is committed to delivering compassionate, inclusive, and high-quality reproductive health care, ensuring every patient feels respected, safe, and supported.

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