Just The Pill offers abortion pills online with a telehealth appointment.

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STEP ONE. Answer the questions below.

STEP TWO. Read and sign two forms.

STEP THREE. Speak with our doctor to receive your abortion pills. Your medication will be delivered to you directly, so you can take your abortion pills in the comfort and privacy of your home.

If you want birth control or STI treatment, please visit our other appointment page.

We offer interpreting services. We are committed to meeting the communication needs of our clients.

Please contact us to receive our Interpreting service.

Abortion By Pill

Please read our Privacy Statement.

I agree to answer all questions truthfully and consent to sharing this information with the medical team. I agree that my anonymous data could be used for research and advocacy purposes. I understand that this service requires me to use email and text for communication about my care (unencrypted email and text is usually secure, but may not be 100% secure). I consent to this. All identifying information will remain confidential. I can withdraw my consent at any time by emailing pill@justthepill.com. *

Please contact us.

We have some specific questions about the services you are requesting, some general questions about your health, and then information for our records:

Do you have an unwanted pregnancy? *

Yes, and I need an abortion.
Yes, but I would like information about options other than abortion.

If you would like to discuss all of your pregnancy options please visit: www.all-options.org.

Did you do an ultrasound or pregnancy test? *

Yes, I did a pregnancy test.
Yes, I did an ultrasound.
No, I did not do an ultrasound or pregnancy test.

When did you get an ultrasound?

How far along were you?

Please take a home pregnancy test and then return to our website.

Select the first day of your last regular menstrual period: *

This is important so that we can give you the right information about the abortion or miscarriage process.

Do you feel that this is accurate within one week? *

Are you currently experiencing any symptoms of pregnancy? *

Nausea
Vomiting
Breast tenderness
All of the above
None of the above
Other

If other, please explain:

Are you sure you want to have medication abortion and no one is forcing you? *

I am sure and nobody is forcing me.
No, I am not sure.

If you cannot discuss your situation with a healthcare provider, we advise you to talk about it with a good friend, a relative or another trusted adult. It is very important that your decision is being made free of coercion.

Are you able to get to a hospital or a facility that can provide basic medical care (like a clinic or doctor’s office) in 60 minutes or less? *

Just as when you give birth, it is important that you are near a facility that can provide basic medical care in case complications occur, even though they are very rare.

In case of a complication, I can contact a partner, neighbor or friend to help me get to a hospital or facility that can provide basic medical care. *

Current / past medical conditions (check all that apply):

Breast Cancer
Current smoker
History of migraines
History of DVT/PE (blood clot in a vein or in the lungs)
Cirrhosis
Liver tumor
Diabetes
Hypertension (high blood pressure)
Gallbladder disease
Bariatric surgery
History of stroke
Ischemic heart disease

My periods are typically: *

Normal
Irregular or sometimes irregular

Are you currently experiencing any of the following:

Abnormal vaginal discharge
Fever

Do you have a health history of either of the following:

Anemia
High blood pressure

Please indicate if you have any of the following:

Vaginal bleeding or spotting in the last week
Pelvic pain in the last week
History of ectopic pregnancy (pregnancy outside the uterus)
Currently have an IUD in place

These are all risk factors for an ectopic pregnancy and any yes answer will be reviewed in your consultation with the physician.

Please indicate if you have any of the following:

Allergy to Misoprostol or Mifepristone or another prostoglandin
Chronic adrenal failure
Hemorrhagic disorder (bleeding disease)
Inherited Porphyrias

Do you have any of the diseases mentioned above? *

I don't have an allergy to Misoprostol or Mifepristone or another prostoglandin; chronic adrenal failure; hemorrhagic disorder (bleeding disease); or inherited Porphyrias.
I have one of the above mentioned diseases.

The treatment can only be used when a person has no serious illness. The mentioned diseases are very rare. If you are not already aware of them, you probably don't have them. Any yes answers will be reviewed in your consultation with the physician.

Stop: you cannot have the treatment with your illness.
Depending on your illness, you may still be able to have a surgical treatment. Please contact us for help.

Do you have any health conditions or diseases of your lungs, heart, kidneys, liver, thyroid, or any health conditions the doctor should know about you? *

If yes, please explain:

Do you take any regular prescription medications? *

If yes, which medication(s) do you take?

Do you know your blood type? *

If yes, what is your blood type?

Do you have any allergies to any medications? *

If yes, what are they?

Times have you been pregnant (including the present one)? *

How many abortions have you had? *

How many miscarriages have you had? *

How many children do you have, if any? *

Your name and address

Please give your correct name and address. All correspondence will be sent to your email address or texted to a phone number. All information will remain confidential.

Name *

First

Last

Pronouns

Birth date *//

Phone *

Email *

What is the best way to contact you? *

Text
Email
Phone call

If we have to call you, is it okay to leave a message?

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Please upload a Photo ID (Any state ID or passport)

Click or drag a file to this area to upload.

The State of Minnesota requires us to ask the next 3 questions.

Are you married? *

What is the highest level of education you have completed so far? *

8th grade or less
9th-12th grade, no diploma
High school graduate or GED completed
Some college credit, but no degree
Associates degree (e.g., AA, AS)
Bachelor’s degree (e.g., BA, AB, BS)
Master’s degree (e.g., MA, MS, MBA)
Doctorate (e.g., PhD, EdD) or Professional degree (e.g., MD, DDS, DVM, JD)

What is your race or ethnicity? (check one or more) *

White
Black or African American
Latino/Latina/Latinx
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Other

Other Asian (please specify)

Other Pacific Islander (please specify)

Other (please specify)

Latino/Latina/Latinx

Mexican, Mexican American, Chicana
Puerto Rican
Cuban
Other

Do you have Medical Assistance (Medicaid) through the state of Minnesota? *

Please upload your Medical Assistance Card

Click or drag a file to this area to upload.