Note: Care Net Pregnancy Center does not provide or refer for abortion or abortifacients.

The fact that abortion is legal does not guarantee a high standard of medical care. If you are seeking an abortion, you need to know your legal rights:

• You have the right to insist that only a licensed physician can perform your abortion.



• You have the right to know whether the physician has ever had his or her medical license suspended.



• You have the right to verify that the physician has medical malpractice insurance to protect and compensate you or your family in case you are injured or killed during the procedure.



• You have the right to be immediately transferred by ambulance to the nearest emergency hospital or trauma center if you are injured during the abortion procedure.

Also, women considering abortion should never sign a waiver releasing the doctor, abortion clinic or staff from liability for abortion-related injuries. Even if a woman has signed such a waiver, the document has virtually no legal authority. Women injured during an abortion retain the right to seek financial compensation in a court of law.

If you are thinking about having an abortion, print out the form below and have your abortion provider complete and sign it. Do not allow anyone to perform an abortion on you who refuses to provide the following information:     Click Here to download a printable version of the form.

• Physician's name
• Name of facility where procedure will be performed
• City and state where facility is located
• Name of malpractice insurance company
• State where insurance company is located
• Policy number
• Policy limit
• Expiration date
• Name of nearest trauma center or emergency hospital

By my signature below, I certify that the information above is true and accurate and that: (a) I am a physician licensed to practice medicine in the state where this abortion is to be performed, (b) I have a current and fully paid malpractice insurance policy with the company named above, (c) my license to practice medicine has never been suspended or revoked in this or any other state, (d) I have no claims or judgments against me for medical malpractice, personal injury or wrongful death, and (e) if you are injured during your abortion you will be immediately transferred by ambulance to the emergency facility named above.