abortion clinics in knoxville tn - knoxville center for reproductive health - kcrh.com abortion clinic  

If you would like to reduce the amount of time spent at your appointment, please download the appropriate forms, print, complete and bring them with you.

NOTE: The following forms are made available to you online in Adobe Reader. Please access www.adobe.com for a free download.

» Medical History [pdf]
» Ultrasound Consent [pdf]
» Surgical Abortion Informed Consent [pdf]
» Medical Abortion (Abortion by Pill) Informed Consent (Must be less than 9 weeks from last menstrual period) [pdf]
» Abortion Questionnaire [pdf]
» Parental Consent Form (Under the age of 18) [pdf]
  * If you feel you are unable to tell your parent or legal guardian, you will need a judicial bypass. Please call our office for assistance.

Please note: The State of Tennessee requires the consent of one parent for a minor patient (under 18 years of age). KCRH must document that we have obtained consent. To do so, all the following requirements must be met:

1) The minor patient’s parent or legal guardian must accompany the patient to her appointment.

2) Photo identification of the parent or legal guardian must be brought to the appointment.

3) Identification of the minor patient (preferably photo) must be brought to the appointment.

4) The patient’s birth certificate with the parent listed on it. If a legal guardian, the court papers showing guardianship must be brought to the appointment.

5) If the names have changed since the paperwork was issued, whatever legal paperwork exists to show the name changes from past to current must also be brought to the appointment (i.e. marriage licenses, adoption papers, etc.)

Please call if you have questions; the staff will be happy to help.


 
 
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Knoxville Center for Reproductive Health - Abortion Clinic in Tennessee
1547 W. Clinch Avenue, Knoxville, TN 37916 | 865-637-3861 or 800-325-5357