Clinic Information

* – these fields are required

1. Where do patients find you?

Clinic, health center, or practice name *
Address *
City / Town *
State *
Zip / Postal Code *
Web address
Phone number *
General e-mail address

2. Which services are offered onsite at your location?

Birth Control Offered

3. What methods of contraception do you offer on-site at your location? (Check yes or no. If unsure, leave blank) *

4. What types of Emergency contraception services are available at your location?

Abortion Services

5. Do you offer abortion?

Funding and Insurance

6. Does this site receive public funding? (Check yes or no. If unsure, leave blank)

7. Describe your location's acceptance of health insurance. (Check all that apply)

8. Describe the financial assistance at your location. (Check all that apply)

other:

Features of Your Location

9. Which language(s) other than English are spoken at your location?

other languages:

10. Check all that apply to your location

11. How can we contact you with further questions?

Name *
Title
Email address *
Direct phone number

12. Public Comments

Feel free to express any comments that can be publicly displayed in Bedsider's Clinic Finder:

13. Private Comments

Feel free to share any comments with the Bedsider staff. These comments will not be made public on Clinic Finder. We'd love to hear from you!

Add or Edit Your Clinic for Bedsider.org

Clinic Information
* – these fields are required

1. Where do patients find you?

2. Which services are offered onsite at your location?

Birth Control Offered

3. What methods of contraception do you offer on-site at your location? (Check yes or no. If unsure, leave blank) *

4. What types of Emergency contraception services are available at your location?

Abortion Services

5. Do you offer abortion?

Should your listing be visible to the public or should it be protected (only visible to verified patient navigators and abortion funds)?

What type(s) of abortion do you provide?

Please provide the URL to the webpage where your abortion services are listed.

If available, please add a link to the page on your website where we can find abortion pricing information.

Abortion Procedure

How far into pregnancy do you offer the abortion procedure?

Abortion Pill (In-Person)

How far into pregnancy do you offer the in-person abortion pill?

Abortion Pill (Telehealth)

How far into pregnancy do you offer the abortion pill through telehealth?

We are looking for the last day an abortion seeker could have their telehealth consultation with you (asynchronous visit, video visit, etc).