One moment please...
Application for Assistance
Officeassistant@nmrcrc.org

Please treat our staff and volunteers with respect and dignity by answering truthfully and completely, so that we can provide the best care for you. Our work is grounded in religious principles of love and acceptance of all people, and we believe that together we can end the shame and stigma associated with abortion.

Tell us about yourself
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

If you live in Texas, you must contact Fund Texas Choice at http://fundtexaschoice.org/need-help/ before we can help you.

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Some states requires teens to tell their parents or get their parents permission. New Mexico does NOT.
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DATE
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TIME
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Any that apply
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Or your parents, if you are still living with them. Or your partner/spouse if you don't work and live together.
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Do you, or your family receive any government assistance?
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Does your husband, partner, or boyfriend hurt you or your children, threaten to hurt you or your children, or say mean things to you or about you or your children? Do they threaten or hurt your pets?
Tell us about your pregnancy
It is against the law for a husband, live-in partner, or boyfriend to force you to have sex or have sex with you when you can't say yes or no.
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Were you using any type?

birth control
Tell us how we can help you
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While in Albuquerque
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How will you be getting to Albuquerque?
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IF YOU NEED A VOLUNTEER TO PICK YOU UP, WE MUST HAVE THE NAME OF YOUR AIRLINE AND FLIGHT #, OR BUS/TRAIN # AND ESTIMATED TIME OF ARRIVAL!
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We can only accommodate one support person.
Tell us how to make you comfortable
You'll be staying in the home of one of our volunteer families. What do they need to know to make sure you are comfortable?
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Do you smoke cigarettes, cigars, or use chewing tobacco?
Are you allergic to any food, pets, soap, etc?




Just a couple more questions

All of our religious counselors are pro-choice, no shaming.
We have affiliates in other states and in Washington, DC. Would you like to know more about who we are and what we do?

If you're not, ask the clinic if you qualify for assistance from the National Abortion Federation.

Please tell us the name of the fund(s) that is helping you so we can make sure we're working together to get you the best help.

Click here to find the National Abortion Federation Hotline.

Click here to find the National Network of Abortion Funds.

We are part of a network of funds in other states and internationally. Would you like to know more about who we are and what we do?
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We will only share this information if we think another fund can help you along with our help or help you better than we can.
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