Get Pills from Southern Woven

1
Are these pills for you or someone else?* This field is required.It is ok to be helping someone get pills, but you CANNOT fill out the other medical form for someone else ---- even if they are your sibling, partner, or child. The person taking the pills needs to be the one who consents to their medical care.
Yes, the pills are for me.
I am helping them right now but they will be the one filling the medical forms out.
No, the pills are for someone else who isn't going to be involved in the intake process.
2
Where do you need the pills sent?* This field is required.They can be sent to you, or sent to a trusted friend or family member.
AK - Alaska
ID - Idaho
FL - Florida
LA - Louisiana
OK - Oklahoma
NY - New York
Other - Somewhere Else
3
Are you 16 or older?* This field is required.Right now we are only set up to help people 16 and older in your state..
Yes
No
4
How long ago was the first day of your last normal period?* This field is required.Normal period just means what's normal for you! Medically we count your pregnancy from the first day of your last period.
I am not pregnant and need the pills for the future.
I'm pregnant, but it was less than a month ago
Between 1 month ago and 3 months ago
More than 3 months ago
5
Your last period was a long time ago, so we might need more information.* This field is required.Your provider may need reco Your provider might need to see medical records or ask you to get an ultrasound.
I have records from a doctor that I can send through the website when you request them, and I'll find them and get them ready now.
I don't have any records right now that show how far along I am, but I can work with the provider to find a low-cost ultrasound or other test if it's needed. (Southern Woven works hard to maintain a list of places and resources that have this care).
I have not seen a doctor or had an ultrasound, and I would not be able to get one even if I need to.
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