Request An Appointment

To request an appointment for an abortion, please fill out the following form. After requesting an appointment online, we will contact you as soon as possible, usually by the next morning. If you have not heard from us after 24 hours, please contact us at (586) 774-4190.

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Confidentiality Notice:
Your information will be transmitted by secured, encrypted e-mail. By providing and submitting your confidential information, you accept the risk of sending this information by e-mail to Eastland Women’s Clinic personnel. When submitting by e-mail, you also agree not to hold Eastland Women's Clinic, including its employees or agents, liable for any damages you may incur as a result of the transfer or use of this information.