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Reissued : MAY 2018SEXUAL HEALTH ETC FORM (These details must be uploaded to PharmOutcomes within 24 hours of the consultation) Name Date of Birth / Postcode:Ethnicity/Reconsultation reassessment
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How to fill out sexual health ehc form

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How to fill out sexual health ehc form

01
To fill out a sexual health EHC form, follow these steps:
02
Provide your personal information like name, date of birth, and contact details.
03
Answer questions about your previous sexual activity, including the date and type of intercourse.
04
Provide details about the contraceptive method used (if any) during the sexual encounter.
05
Indicate whether you experienced any failures or incidents that may lead to pregnancy, such as condom breakage.
06
Include any additional relevant information, such as the need for emergency contraception due to sexual assault.
07
Sign and date the form to confirm the accuracy of the information provided.
08
Submit the form to the appropriate healthcare provider or clinic.

Who needs sexual health ehc form?

01
Anyone who requires emergency contraception (EHC) after engaging in unprotected sex or experiencing contraceptive failure needs to fill out a sexual health EHC form. This includes individuals of reproductive age who may be at risk of unintended pregnancy and wish to access emergency contraception to prevent pregnancy.
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The sexual health EHc form is a document used to report and monitor sexual health data and trends, often required by health authorities to ensure public health safety and management.
Typically, healthcare providers, clinics, and organizations that offer sexual health services are required to file the sexual health EHc form.
To fill out the sexual health EHc form, gather all pertinent patient data, including demographic information and details related to sexual health services provided, then complete the form as per the guidelines provided by the health authority.
The purpose of the sexual health EHc form is to collect data that helps monitor sexual health trends, informs public health policies, and improves healthcare services related to sexual health.
Information that must be reported on the sexual health EHc form typically includes patient demographics, health service details, diagnoses, treatment provided, and any necessary follow-up care.
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