Request Appointment

Request Appointment | Abortion Care

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First Name*

Last Name

Date of Birth*

Phone*

Email*

How do you prefer to be contacted?*

(If email is your preference, remember to check your junk/spam folder!)

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Phone

May we identify ourselves as Blue Mountain Clinic if we call?*

We will always contact you based on your preference, but sometimes it’s necessary to reach out by phone.

Yes

Can we leave a voicemail if necessary?*

Yes

Approximate date of your Last Menstrual Period (LMP)

Please select the kind of appointment you would like to schedule:*

We offer in-person, telehealth, and completely online options. If you cannot or do not want to travel to our clinic, we can also mail abortion pills through our meds by mail option. You can read more about our abortion care services here on our website and we are always happy to discuss your options with you! Please submit the following info and we will get back to you during regular clinic hours. Thank you!