Request an Abortion Apppointment online to Michigan abortion clinic Heritage Clinic for Women abortion clinic in Grand Rapids, Michigan

Request An Abortion Appointment

Request an abortion appointment through our secured online request form.

This service is only a request to schedule an appointment. It is NOT a confirmed appointment. You MUST speak directly with one of our staff members in order to schedule an appointment.

Responses to abortion appointment requests may take up to 24 hours. If this is a clinical concern please contact Heritage Clinic for Women directly by phone.

Calls answered: Monday & Tuesday 9 AM – 4 PM | Wednesday through Friday 8 AM – 4 PM

The information you will be providing below is highly secured and will only be used to confirm your Request for an Appointment with Heritage Clinic for Women.

Important Notice: Due to Michigan’s legislation ALL women in the state of Michigan choosing to have an abortion must schedule an abortion appointment and receive specific state mandated verbal and printed material about pregnancy, parenting and abortion MORE than 24 hours before the abortion procedure will occur.

Patient's Name*
First Last
Patient's Date of Birth*
MM slash DD slash YYYY
Preferred Method of Contact*
- Phone
- Email
Patient's Phone Number*
Patient's Email Address*
First day of last period
MM slash DD slash YYYY

Enter the date of the first day of your last normal period
Type of Appointment*
Requested Date*
Requested Time*
Additional Information
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Sensitive Care
Confidential Services
Compassionate Staff