Fees & Forms

Phoenix Clinic Fees & Forms

SERVICE FEE
Urine pregnancy test Free
Blood pregnancy test $25
Office visit (infection check, exam, breast exam, IUD removal, or bump check) $30
Well woman exam with pap $55
Well woman exam with pap, Chlamydia & Gonorrhea $75
Well woman exam with pap, Chlamydia, Gonorrhea, HIV & Syphilis $100
STI testing – exam, Chlamydia & Gonorrhea $50
STI testing – exam, Chlamydia, Gonorrhea, HIV & Syphilis $80
HIV test $25
Limited Ultrasound $30
Herpes test (in addition to office visit) $30-$80
HPV treatment (in addition to office visit) $20-$60
Hepatitis B (in addition to office visit) $20
Hepatitis C (in addition to office visit) $30

STD testing and treatment is also available for men; the same charges apply.
Call 602-305-5100 for an appointment or for prices of other lab tests.

Many factors can affect the price of an abortion, call for more information.

 

Forms

 

Personal Health History:

All clients will be asked to complete a Personal Health History form prior to receiving services. An original signed form is required for obtaining service. The forms below are provided for reference only, and completed forms will not be accepted through e-mail. Forms are available in our office; or you may print the form, complete it, and bring it with you to your appointment.

Women’s Forms:

Men’s Forms:

 

Release of Medical Information:

If you wish to obtain a copy of your medical record, or have a copy sent to another provider, please print the Authorization to Release Information form, complete it in full, and return it to our office in person, by e-mail, or by fax @ (602) 870-7697. Photo identification is required. Due to HIPAA regulations, Medical Information cannot be released via e-mail.

We are here for you...

We're here to help you make an informed choice about your unplanned pregnancy.


9303 N. 7th St. Phoenix, AZ 85020
3516 W. McDowell Phoenix, AZ 85009
Directions 7th » Dir McDowell »

Contact Us:

Call Us: 602-305-5100
Text Us: 909-529-2035
Español: 602-269-3131

Appointments:

Schedule Appointment »

Get Directions

9303 N. 7th St. Phoenix, AZ 85020
3516 W. McDowell Phoenix, AZ 85009
Directions 7th » Dir McDowell »