Add or Edit Your Clinic for Bedsider.org
Clinic Information
*
– these fields are required
1.
Where do patients find you?
Clinic, health center, or practice name
*
Address
*
City / Town
*
State
*
– Choose State –
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Washington, D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Puerto Rico
Northern Mariana Islands
U.S. Minor Outlying Islands
Virgin Islands
Zip / Postal Code
*
Web address
Phone number
*
General e-mail address
2.
Which services are offered at your location?
Birth Control Offered
3.
What methods of contraception do you offer? (Check yes or no. If unsure, leave blank)
*
4.
Describe the availability of LARC services at your location. (Check yes or no. If unsure, leave blank)
5.
Describe the availability of these methods at your location
Abortion Services
6.
Do you offer abortion?
Should your listing be visible to the public or should it be protected (only visible to verified patient navigators and abortion funds)?
What type(s) of abortion do you provide?
Please provide the URL to the webpage where your abortion services are listed.
Web address
Up to what gestational age do you provide
aspiration/procedural abortions?
Should your clinic's
aspiration/procedural gestational age limit
be visible to the public or should it be protected (only visible to verified patient navigators and abortion funds)?
Up to what gestational age do you provide
medical abortions (the abortion pill)?
Should your clinic's
medical gestational age limit
be visible to the public or should it be protected (only visible to verified patient navigators and abortion funds)?
Funding and Insurance
7.
Does this site receive public funding? (Check yes or no. If unsure, leave blank)
8.
Describe your location's acceptance of health insurance. (Check all that apply)
9.
Describe the financial assistance at your location. (Check all that apply)
other:
Features of Your Location
10.
Which language(s) other than English are spoken at your location?
other languages:
Abkhazian
Afar
Afrikaans
Akan
Albanian
American Sign Language (ASL)
Amharic
Arabic
Aragonese
Armenian
Assamese
Avaric
Avestan
Aymara
Azerbaijani
Bambara
Bashkir
Basque
Belarusian
Bengali
Bislama
Bosnian
Breton
Bulgarian
Burmese
Cantonese Chinese
Catalan
Chamorro
Chechen
Chichewa
Chinese
Church Slavic
Chuvash
Cornish
Corsican
Cree
Croatian
Czech
Danish
Divehi
Dutch
Dzongkha
English
Esperanto
Estonian
Ewe
Faroese
Fijian
Finnish
French
Fulah
Gaelic
Galician
Ganda
Georgian
German
Greek
Kalaallisut
Guarani
Gujarati
Haitian Creole
Hausa
Hebrew
Herero
Hindi
Hiri Motu
Hmong
Hungarian
Icelandic
Ido
Igbo
Ilocano
Indonesian
Interlingua
Interlingue
Inuktitut
Inupiaq
Irish
Italian
Japanese
Javanese
Kannada
Kanuri
Kashmiri
Kazakh
Central Khmer
Kikuyu
Kinyarwanda
Kirghiz
Komi
Kongo
Korean
Kuanyama
Kurdish
Lao
Latin
Latvian
Limburgan
Lingala
Lithuanian
Luba-Katanga
Luxembourgish
Macedonian
Malagasy
Malay
Malayalam
Maltese
Mandarin Chinese
Manx
Maori
Marathi
Marshallese
Mongolian
Nauru
Navajo
North Ndebele
South Ndebele
Ndonga
Nepali
Norwegian
Norwegian Bokmål
Norwegian Nynorsk
Sichuan
Occitan
Ojibwa
Oriya
Oromo
Ossetian
Pali
Pashto
Persian
Polish
Portuguese
Punjabi
Quechua
Romanian
Romansh
Rundi
Russian
Northern Sami
Samoan
Sango
Sanskrit
Sardinian
Serbian
Shona
Sindhi
Sinhala
Slovak
Slovenian
Somali
Southern Sotho
Spanish
Sundanese
Swahili
Swati
Swedish
Tagalog
Taiwanese Hokkien
Tahitian
Tajik
Tamil
Tatar
Tegali
Telugu
Thai
Tibetan
Tigrinya
Tonga
Tsonga
Tswana
Turkish
Turkmen
Twi
Uighur
Ukrainian
Urdu
Uzbek
Venda
Vietnamese
Volapük
Walloon
Waray
Welsh
Western Frisian
Western Persian
Wolof
Xhosa
Yiddish
Yoruba
Zhuang
Zulu
11.
Check all that apply to your location
12.
How can we contact you with further questions?
Name
*
Title
Email address
*
Direct phone number
13.
Public Comments
Feel free to express any comments that can be publicly displayed in Bedsider's Clinic Finder:
14.
Private Comments
Feel free to share any comments with the Bedsider staff. These comments will not be made public on Clinic Finder. We'd love to hear from you!