Office of Rural Programs
Ambulatory Scripts: Contraception
| History | 5 Ps 1. Partners 2. Practices 3. Protection from STIs 4. Past History of STIs 5. Pregnancy Intention Past or current methods Side effect tolerance (bleeding, hormones) |
|---|---|
| Social Hx | (tobacco use, work/school schedule that might impact adherence) |
| PMHx | HTN, DM, renal disease, migraines, cancer |
| Medications | any potential drug interactions, WHO eligibility criteria |
| Studies | pregnancy testing |
| Patient Education | Start plan, back up method, if low reliability method provision of Plan B and PNV |
Table last updated 2/15/2023 | Script Index | Feedback: rgree3@uw.edu | Download pdf for printing