• Please complete as many questions as possible to ensure that referrals to your service are appropriate.
  • The email address that you provide is for verification purposes only, and will not be distributed to callers or visible via the website.
  • Please click on the "done" button at the end of the form to ensure that your registration is processed.
Children by Choice will contact you with any questions about your registration, as necessary.
If you are happy to provide referrals for surgical termination but are unaware of your local pathways, please send us an email to the contact below

You can contact Children by Choice at any time to change your registration, or deregister your service.
  • Phone: 1800 177 725
  • Email:
For more information about Children by Choice, please visit

Question Title

1. By continuing in this survey you are confirming you have read and agree to our disclaimer.