Requesting changes for Cook County Health – Reproductive Health Services
Find the section(s) that need updating, click update, and add the correct information. When you're done updating the section(s), scroll to the bottom of the form, enter your email (this is required in case we need to follow up) and click the Submit Change Request button.
Provider Name
Website
Provider Hours
Timezone: Central Standard Time
Monday
open 24 hours
Tuesday
open 24 hours
Wednesday
open 24 hours
Thursday
open 24 hours
Friday
open 24 hours
Saturday
open 24 hours
Sunday
open 24 hours
Member of ACN?
Member of NAF?
Phone
Appointment form link (url)
Pricelist link (url)
Pricing information
Cost of abortion pills
Additional information about provider services
Information for minors
How EARLY does the provider offer abortions (in weeks + days)?
Surgical abortion offered?
For surgical abortions, how late in pregnancy will the provider go? (in weeks + days)
Medication abortion offered?
For medication abortions, how late in pregnancy will the provider go? (in weeks + days)
Translation services offered?
“High risk” abortions supported?
Free pregnancy tests offered?
Does Provider Accept Medicaid?
Abortion pills by mail offered?
Link to Provider Yelp (URL)
Street Address
City
State
Zip
Do you know how far in advance they're booking appointments?
0 edits suggested
This will only be used to follow up if we have questions