New Version Aria Intake Form

1
Are you the person who will get the abortion?* This field is required.
Yes
No, I am scheduling for someone else
2
Patients should schedule their OWN appointments. You can share our website with the patient and help them schedule, but do not submit medical information for someone other than yourself. This is to ensure safety and quality care.
3
Date of Birth* This field is required.
as listed on your photo ID
Month
Day
Year
4
Qualifying age
5
We are sorry, we can only serve people 18 years and over.

You have many options:

Aid Access can mail pills to your home address, in all 50 states.

Trust Women and Planned Parenthood see people under the age of 18.

The State of Kansas requires parents to sign notarized consent forms in order for a minor to get an abortion. It may be easier to easier to get care in New Mexico, Illinois or Minnesota because these states do not have parental consent laws.

For more help, call:

If/When/How Judical Bypass Helpline (844) 868-2812

Jane's Due Process (866) 999-5263 helps minors from Texas get abortion care.
6
Have you had a positive pregnancy test?* This field is required.
Yes, my pregnancy test is positive.
No, my pregnancy test is negative.
No, I have not done a pregnancy test.
7
You must have a positive pregnancy test before scheduling an abortion appointment. An inexpensive drug store urine test works well. A doctor's office visit is not required to do a pregnancy test.

There are many things other than being pregnant that can make you miss a period. If your pregnancy test is negative, please see a primary care provider to discuss other reasons why you either missed a period or have pregnancy symptoms.
8
How many people live in your household?
Please Select
Please Select
1 (just me)
2
3
4
5
6
7
8
more than 8
9
Do you make less than $16,572 in a year ($1,381 in a month)?* This field is required.
Yes, I make LESS than $16,572 in a year.
No, I make MORE than $16,572 in a year.
10
Do you make less than $16,572 in a year ($1,381 in a month)?* This field is required.
Yes, I make LESS than $16,572 in a year.
No, I make MORE than $16,572 in a year.
11
Do you make less than $22,488 in a year ($1,874 in a month)?* This field is required.
Yes, I make LESS than $22,488 in a year.
No, I make MORE than $22,488 in a year.
12
Do you make less than $22,488 in a year ($1,874 in a month)?* This field is required.
Yes, I make LESS than $22,488 in a year.
No, I make MORE than $22,488 in a year.
13
Do you make less than $28,404 in a year ($2,367 in a month)?* This field is required.
Yes, I make LESS than $28,404 in a year.
No, I make MORE than $28,404 in a year.
14
Do you make less than $28,404 in a year ($2,367 in a month)?* This field is required.
Yes, I make LESS than $28,404 in a year.
No, I make MORE than $28,404 in a year.
15
Do you make less than $34,320 in a year ($2,860 in a month)?* This field is required.
Yes, I make LESS than $34,320 in a year.
No, I make MORE than $34,320 in a year.
16
Do you make less than $34,320 in a year ($2,860 in a month)?* This field is required.
Yes, I make LESS than $34,320 in a year.
No, I make MORE than $34,320 in a year.
17
Do you make less than $40,236 in a year ($3,353 in a month)?* This field is required.
Yes, I make LESS than $40,236 in a year.
No, I make MORE than $40,236 in a year.
18
Do you make less than $40,236 in a year ($3,353 in a month)?* This field is required.
Yes, I make LESS than $40,236 in a year.
No, I make MORE than $40,236 in a year.
19
Do you make less than $46,152 in a year ($3,846 in a month)?* This field is required.
Yes, I make LESS than $46,152 in a year.
No, I make MORE than $46,152 in a year.
20
Do you make less than $46,152 in a year ($3,846 in a month)?* This field is required.
Yes, I make LESS than $46,152 in a year.
No, I make MORE than $46,152 in a year.
21
Do you make less than $52,068 in a year ($4,339 in a month)?* This field is required.
Yes, I make LESS than $52,068 in a year.
No, I make MORE than $52,068 in a year.
22
Do you make less than $52,068 in a year ($4,339 in a month)?* This field is required.
Yes, I make LESS than $52,068 in a year.
No, I make MORE than $52,068 in a year.
23
Do you make less than $57,984 in a year ($4,832 in a month)?* This field is required.
Yes, I make LESS than $57,984 in a year.
No, I make MORE than $57,984 in a year.
24
Do you make less than $57,984 in a year ($4,832 in a month)?* This field is required.
Yes, I make LESS than $57,984 in a year.
No, I make MORE than $57,984 in a year.
25
Unique ID
26
Ban state?
27
Financial need?
28
Fund
Please Select
Please Select
none
TAF
NAF
NAF_plus_Sliding_Scale
NAF_plus_KAF
MOAF_fully_funded
MOAF_Sliding_Scale
AASN_fully_funded
AASN_Sliding_Scale
29
The cost of your abortion at Aria Medical is $490.

If this is a hardship, Medicaid covers abortion in your home state – you can go to abortionfinder.org if you would like to find a clinic in your state. You can also go to ineedana.com to search by zip code.
30
The cost of your abortion at Aria Medical is $490, $295 or $45, sliding scale. We accept Cash App, major credit cards, debit cards, and also cash.

The fee includes everything: the doctor visit, all medications, and an ultrasound (if needed).

You choose the cost you can afford. If the price is a hardship for you, Aria Medical works with donors to cover part or all of your visit.
31
The cost of your abortion at Aria Medical is $245 or $45, sliding scale.

We accept Cash App, major credit cards, debit cards, and also cash.

The fee includes everything: the doctor visit, an ultrasound (if needed) and all medications.

You choose the cost you can afford. If the price is a hardship for you, Aria Medical Foundation works with donors to cover part or all of your visit.
32
The cost of your abortion at Aria Medical is $140.

We accept Cash App, major credit cards, debit cards, and also cash.
The fee includes everything: the doctor visit, an ultrasound (if needed) and all medications.

If you cannot afford the fee, please let the front desk know, and we will work out a fee that you can afford.
33
Your appointment is fully funded by our donors, including the cost of the visit, medications, and ultrasound (if you need it). You do not need to pay anything.
34
Will you need help covering the costs of travel to Wichita, Kansas?
Yes
No
35
If you want help with travel costs, text or call Midwest Access Coalition at 847-750-6224. They can help you by booking flights or covering costs of gas, bus fares, lodging, childcare or other expenses. If they are closed, please reach out to Aria in the secure app (after you book your appointment) or call us at 316 350 7688 and we may be able to help.
36
Do you need an interpreter? If so, select the language.
Please Select
Please Select
Spanish
Hindi
French
Farsi
Other
37
Which language?
38
Do any of these apply to you?* This field is required.
I have an IUD in place right now.
I have an allergy to prostaglandins, misoprostol or mifepristone
I have a bleeding disorder (including any condition that causes your blood not to clot normally. Anemia is NOT a bleeding disorder)
In the past, I've had heavy bleeding after miscarriage or medication abortion that required transfusion.
I take blood thinners, including Coumadin (warfarin), apixaban (Eliquis), rivaroxaban (Xarelto) or heparin (Lovenox). (NOT including aspirin)
I take steroid pills, injections or infusions more than 5 days a month for a medical condition. (NOT including steroid sprays, creams, inhalers or testosterone)
I have severe adrenal problems
I have porphyria (very rare condition affecting liver and skin)
I have a severe heart condition (like valve disease requiring surgery, heart failure or cardiomyopathy. Palpitations or PVCs don’t count).
I have had an endometrial ablation (procedure that destroys lining of uterus)
I have symptoms like dizziness or severe fatigue from anemia.
No, I have none of these problems.
39
Drug allergies include:
40
The IUD must be removed BEFORE your appointment at Aria.

Please make an appointment with a provider near you to remove it (try bedsider.org if you aren’t sure where to go).

You can remove your own IUD — click here for instructions.

If you got pregnant with an IUD in place, we recommend an ultrasound to find out if you have an ectopic pregnancy. Abortion pills do not treat ectopic pregnancies. Ectopics are treatable by OBGYNs in all 50 states.

If you cannot remove your IUD and you still want an appointment, please call us first (316) 350-7688 so we can help you figure out what to do.

Or call the MA Hotline at 1-833-246-2632 to learn about other options.
41
It may not be safe for you to do a medication abortion. We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your allergy when you make an appointment. If you are allergic to mifepristone, one of the abortion pills, you can still use misoprostol. Misoprostol is about 85% effective, when used without mifepristone. If you would like to do a miosprostol-only abortion, please go to the MAP and they can send pills by mail.
Call us at (316) 350-7688 if you have questions
42
It may not be safe to have a medication abortion if you have a bleeding disorder.
We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your condition when you make an appointment.
Call us at (316) 350-7688 if you have questions.
Or contact the MA Hotline at 1-833-2632.
43
It may not be safe to have a medication abortion if you needed a transfusion after an abortion or miscarriage. Please call us to discuss your situation (316-350-7688) before scheduling an appointment.
Or go to INeedAnA.com to schedule a procedure. Make sure to tell the clinic about your condition when you make an appointment.
Or contact the MA Hotline at 1-833-2632 to explore other options for medication abortion.
44
It may not be safe to have a medication abortion if you take blood thinners.
We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your condition when you make an appointment.
Call us at (316) 350-7688 if you have questions.
Or contact the MA Hotline at 1-833-2632.
45
If you take daily steroid pills or use steroid injections (not counting testosterone), it may not be safe to use mifepristone.
We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your condition when you make an appointment.
You can still have a medication abortion with misoprostol. Misoprostol is about 85% effective, when used without mifepristone. If you would like to do a miosprostol-only abortion, please go to the MAP and they can send pills by mail.
Call us at (316) 350-7688 if you have questions
46
If you have severe adrenal problems, it may not be safe to use mifepristone.
We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your condition when you make an appointment.
You can still have a medication abortion with misoprostol. Misoprostol is about 85% effective, when used without mifepristone. If you would like to do a miosprostol-only abortion, please go to the MAP and they can send pills by mail.
Call us at (316) 350-7688 if you have questions
47
If you have porphyria, it may not be safe to use mifepristone.
We recommend a procedure — please go to INeedAnA.com to find a clinic that works for you. Make sure to tell the clinic about your condition when you make an appointment.
You can still have a medication abortion with misoprostol. Misoprostol is about 85% effective, when used without mifepristone. If you would like to do a miosprostol-only abortion, please go to the MAP and they can send pills by mail.
Call us at (316) 350-7688 if you have questions.
48
It may be not safe to have a medication abortion if you have a severe heart condition. Please call us at (316) 350-7688 to review your medical history before you schedule an appointment. Or you could go to abortionfinder.org or ineedana.com to schedule a procedure instead. Make sure to tell the clinic about your condition when you make an appointment.
49
It may not be safe to have a medication abortion if you have had an endometrial ablation, a procedure that destroys the lining of your uterus.

Call us if you have questions about your particular situation: 316 350-7688. Or you can go to INeedAnA.com to schedule a procedure instead. Make sure to tell the clinic about your condition when you make an appointment, as they may require you to do your procedure in an operating room instead of an outpatient clinic.
50
If you have severe anemia, and you have symptoms from anemia like dizziness or fatigue, it may be safer for you to get a procedure abortion. Call us if you have questions about your particular situation: 316 350-7688. Or you can go to INeedAnA.com to schedule a procedure instead. Make sure to tell the clinic about your condition when you make an appointment.
51
Do you have any allergies to drugs? If yes, list here.
52
Are any of these true for you?* This field is required.
I have had an ectopic pregnancy before
I have had a tubal ligation (tubes tied)
I had an IUD in place at the time I got pregnant
None of these are true for me
53
You are at higher risk for an ectopic pregnancy.

An ectopic pregnancy is an abnormal pregnancy growing outside the uterus, usually in the tubes.

We strongly recommend getting an ultrasound before your visit to Aria.

Ectopic pregnancies can be treated in all 50 states. Abortion pills do not work to treat ectopic pregnancies. Please call us if you have any questions: 316-350-7688.
54
No risk factors
55
Patient lists the following risk factors for ectopic pregnancy:
I have an IUD in place right now.
I have an allergy to prostaglandins, misoprostol or mifepristone
I have a bleeding disorder (including any condition that causes your blood not to clot normally. Anemia is NOT a bleeding disorder)
In the past, I've had heavy bleeding after miscarriage or medication abortion that required transfusion.
I take blood thinners, including Coumadin (warfarin), apixaban (Eliquis), rivaroxaban (Xarelto) or heparin (Lovenox). (NOT including aspirin)
I take steroid pills, injections or infusions more than 5 days a month for a medical condition. (NOT including steroid sprays, creams, inhalers or testosterone)
I have severe adrenal problems
I have porphyria (very rare condition affecting liver and skin)
I have a severe heart condition (like valve disease requiring surgery, heart failure or cardiomyopathy. Palpitations or PVCs don’t count).
I have had an endometrial ablation (procedure that destroys lining of uterus)
I have symptoms like dizziness or severe fatigue from anemia.
56
Before you come to Aria, you need to have your IUD removed and have an ultrasound to make sure the pregnancy is in your uterus. Call us if you have questions: (316) 350-7688.
57
Have you had an ultrasound (sonogram) for this pregnancy?* This field is required.
No, I have not had an ultrasound.
Yes, I had an ultrasound and will be 12 weeks or less this coming weekend.
Yes, I had an ultrasound and will be more than 12 weeks this coming weekend.
58
Great. We strongly advise bringing a copy of the ultrasound (sonogram) or the report with you to your appointment, if you have it. It will save time in the clinic.
59
When was the first day of your last menstrual period?* This field is required.
We cannot schedule patients who are more than 12 weeks pregnant, based on last menstrual period or ultrasound.
Month
Day
Year
60
It looks like you are less than 6 weeks pregnant.

Abortion pills work best if you are at least 6 weeks — they fail only 2 out 100 times.

If you are 4 weeks, 15 out of 100 medication abortions do not work, and you may need to repeat the pills.

We recommend scheduling your appointment when you will be at least 6 weeks from your last period.
61
We cannot safely schedule you at Aria if you are more than 12 weeks pregnant. Please go to abortionfinder.org or ineedana.com to schedule a procedure instead. Call (316) 350-7688 if you have questions
62
If one of these apply to you, we STRONGLY recommend you get an ultrasound before you visit.

Breastfeeding

Using pills, patches, rings or shot for birth control

Have irregular periods

Last period was lighter than normal

Any of these make it harder to know how far along you are. If you are over 12 weeks at the time of your visit, we will not be able to give you pills. You would have to arrange a procedure at another clinic on another day.
63
Today's Date
Date
Month
Day
Year
64
11 week calc
65
It costs Aria $490 to provide you a medication abortion. We only charge you what you can afford, between $50 - $490. Follow-up is virtual -- you do not need to come back to the clinic. Your visit lasts 1-2 hours.
I can pay $490.
I need a discount.
I want to get pills mailed to my home – this is a reliable and lower cost option.
66
Mayday.Health is a website listing reliable clinics that send pills by mail. These are the same pills we offer at Aria.

Cost for mail-order pills is typically $5-150 or more.

If you want support or advice about getting pills by mail, contact the Miscarriage and Abortion Hotline 1-833-246-2632.
67
How many people live in your household?* This field is required.
Please Select
Please Select
1 (just me)
2
3
4
5
6
7
8
more than 8
68
Do you make more than $16,572 in a year ($1,381 in a month)?* This field is required.
Yes, I make MORE than $16,572 in a year.
No, I make LESS than $16,572 in a year.
69
Do you make more than $22,488 in a year ($1,874 in a month)?* This field is required.
Yes, I make MORE than $22,488 in a year.
No, I make LESS than $22,488 in a year.
70
Do you make more than $28,404 in a year ($2,367 in a month)?* This field is required.
Yes, I make MORE than $28,404 in a year.
No, I make LESS than $28,404 in a year.
71
Do you make more than $34,320 in a year ($2,860 in a month)* This field is required.
Yes, I make MORE than $34,320 in a year.
No, I make LESS than $34,320 in a year.
72
Do you make more than $40,236 in a year ($3,353 in a month)* This field is required.
Yes, I make MORE than $40,236 in a year.
No, I make LESS than $40,236 in a year.
73
Do you make more than $46,152 in a year ($3,846 in a month)?* This field is required.
Yes, I make MORE than $46,152 in a year.
No, I make LESS than $46,152 in a year.
74
Do you make more than $52,068 in a year ($4,339 in a month)?* This field is required.
Yes, I make MORE than $52,068 in a year.
No, I make LESS than $52,068 in a year.
75
Do you make more than $57,984 in a year ($4,832 in a month)?* This field is required.
Yes, I make MORE than $57,984 in a year.
No, I make LESS than $57,984 in a year.
76
We can give you a $100 discount, using donor funds. You would pay $390.* This field is required.
I can pay $390.
I can’t pay $390 – I need more financial assistance.
77
We can give you a $210 discount, using donor funds. You would pay $280.* This field is required.
I can pay $280.
I can’t pay $280 – I need more help.
78
We can give you a $310 discount, using donor funds. You would pay $180.* This field is required.
I can pay $180.
I can’t pay $180 - I need more help.
79
We can give you $400 discount, using donor funds. You would pay $90.* This field is required.
I can pay $90.
I can’t pay $90 - I need more help.
80
We can give you $415 discount, using donor funds. You would pay $75.* This field is required.
I can pay $75.
I can’t pay $75 - I need more help.
81
We can give you $440 discount, using donor funds. Your appointment cost is $50. Please contact us if $50 presents difficulty for you, or if already have a voucher covering your services: (316) 350 - 7668.* This field is required.
I can pay $50.
82
The answers to these questions help us raise money to help our patients.
83
What state do you live in?* This field is required.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
KANSAS
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Canada
84
In which Kansas county do you live?To skip question, hit next
Please Select
Please Select
Allen
Anderson
Atchison
Barber
Barton
Bourbon
Brown
Butler
Chase
Chautauqua
Cherokee
Cheyenne
Clark
Clay
Cloud
Coffey
Comanche
Cowley
Crawford
Decatur
Dickinson
Doniphan
Douglas
Edwards
Elk
Ellis
Ellsworth
Finney
Ford
Franklin
Geary
Gove
Graham
Grant
Gray
Greeley
Greenwood
Hamilton
Harper
Harvey
Haskell
Hodgeman
Jackson
Jefferson
Jewell
Johnson
Kearny
Kingsman
Kiowa
Labette
Lane
Leavenworth
Lincoln
Linn
Logan
Lyon
Marion
Marshall
McPherson
Meade
Miami
Mitchell
Montgomery
Morris
Morton
Nemaha
Neosho
Ness
Norton
Osage
Osborne
Ottawa
Pawnee
Phillips
Pottawatomie
Pratt
Rawlins
Reno
Republic
Rice
Riley
Rooks
Rush
Russell
Saline
Scott
Sedgwick
Seward
Shawnee
Sheridan
Sherman
Smith
Stafford
Stanton
Stevens
Sumner
Thomas
Trego
Wabaunsee
Wallace
Washington
Wichita
Wilson
Woodson
Wyandotte
85
What county do you live in?* This field is required.
86
What is your zip code?* This field is required.
87
Do you consider yourself to be Hispanic or Latina/e?* This field is required.Your answer helps us raise money so we can offer discounts.
Yes
No
88
How do you identify?
Mexican, Mexican-American or Chicana
Puerto Rican
Cuban
Central American
South American
Other Spanish, Hispanic or Latina
I do not wish to answer
89
Other Spanish, Hispanic or LatinaPlease specify:
90
How would you describe your race? Select all that apply.* This field is required.Your answer helps us raise money so we can offer discounts.
White
Black/African American
Native American
Asian/Pacific Islander
Other
I do not wish to answer.
91
Are you married?To skip question, hit next
No, I am not married.
Yes, I am married.
I do not wish to answer.
92
Before this pregnancy, how many other times have you been pregnant?To skip question, hit next
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
You can leave blank if you do not wish to answer.
93
Prior Pregnancy questionsTo skip questions, hit next
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
number of live childbirths
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
number of living children
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
number of natural miscarriages and stillbirths
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
number of abortions
94
How many living children do you have?To skip question, hit next
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
95
How many natural miscarriages have you had?To skip question, hit next
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
96
Before this pregnancy, how many abortions have you had?To skip question, hit next
Please Select
Please Select
None
1
2
3
4
5
6
7
8
9
10 or more
97
What is the highest level of school you have finished?To skip question, hit next
8th Grade or less
9th-12th Grade (no diploma)
High School Graduate/GED
Some College Credit (No Degree)
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate or Professional Degree
98
Your information is kept private. We follow all state and federal privacy laws. Aria Medical sends texts and emails for reminders and follow-up.
99
What is your first name?* This field is required.
as it appears on your ID
100
What is your last name?* This field is required.
as it appears on your ID
101
Name you wished to be called
if you prefer a name other than what's on your ID
102
Phone Number* This field is required.Please provide the best phone number to reach you. We will send appointment confirmations and follow-up surveys to this number. Carrier rates for SMS texts may apply. We will never share your number outside of our system or use it for marketing purposes.
Please enter a valid phone number.
103
Email
example@example.com
104
We're almost done. Please review and put your initials in each box of the consent form, using a mouse or your finger. Then you can schedule your appointment.
105
Aria Medical offers only medication abortion. Medication abortion uses pills to end a pregnancy, very similar to a miscarriage. After your visit, we will send you a follow-up survey by text. Abortions can also be performed by a procedure; if you want a procedure you need to contact another provider.* This field is required.
106
You understand that Aria will only give abortion pills if your pregnancy is less than 12 weeks. Doing an ultrasound before your visit is the best way to know how far along you are. If you can’t get an ultrasound in advance, Aria will do an abdominal ultrasound during your visit. This is to confirm the pregnancy is in your uterus and to know the number of weeks. We do a vaginal ultrasound only if we cannot see the pregnancy on abdominal ultrasound. If you are over 12 weeks, Aria will help you find a clinic to do a procedure on another day, possibly in another state, if Kansas clinics are booked up.* This field is required.
107
The Aria ultrasound will not diagnose conditions other than pregnancy and is unlikely to show an ectopic pregnancy, if it is there. If we cannot see a pregnancy in the uterus, you can still get the abortion pills during your visit and we will review warning signs of an ectopic pregnancy. You may need to get follow-up labs or a follow-up ultrasound to confirm the abortion worked. If you have an ectopic pregnancy, we will help you to get treatment. Untreated ectopic pregnancy is life-threatening. Treatment of ectopic pregnancy is legal in all 50 states.* This field is required.
108
Abortion pills are extremely safe, even safer than Tylenol. Rare but serious risks of medication abortion include (1) undiagnosed ectopic pregnancy with rupture, causing life-threatening bleeding without medical care, (2) hemorrhage or retained tissue, requiring a procedure for treatment, (3) infection, or (4) death. Death in childbirth is 10-20 times more likely than death from abortion.* This field is required.
109
There is a very small chance that the medications do not work and you stay pregnant. If this happens, Aria will help you do a second medication abortion or find a clinic to have a procedure. Aria does not do procedures – you would need to have the procedure in another clinic, potentially in another state because of high demand in Kansas.* This field is required.
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I agree to receive SMS texts for appointment reminders and follow-up care. I understand my cell phone carrier may impose charges for SMS texts. I will reply to the follow-up surveys sent via text after my appointment. The survey is VERY important. We want to make sure the pills worked. I may opt out of texts at my own risk by replying "STOP" by text.* This field is required.
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Before hitting submit and scheduling your appointment, please let us know how you found us.
Recommendation from friend or family
Google search
INeedAnA.com
PlanCPills.org
AbortionFinder.org
Referred/Other
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Your visit at Aria Medical Clinic usually lasts 1-2 hours. You will meet with a warm and welcoming staff to answer all of your questions. You will receive an abdominal ultrasound if you haven't had one yet. If you have already had a sonogram, please bring the image or the report. You will see an experienced medical provider via live video.

We make sure you understand the process and all your questions are answered before you leave.
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Was the first day of your last period less than 6 weeks ago?
If yes, please schedule your appointment 1-2 weeks from now.

If you schedule too early (less than 5 weeks from your period), the pills fail 15 out of 100 times — meaning you stay pregnant and have to take them again.
The best results are when you are 6-11 weeks after the first day of your last period.

Don’t worry — we make sure we have open appointments every weekend, and you can book 3 weeks in advance.
Call us at (316) 350-7688 if you have questions

Click SUBMIT below to schedule your appointment.
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