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Referral Form Patient Details: Patient Name:___Date of Birth:___/___/___Phone Number:H: ___ M: ___Reason for Referral: Surgical Termination of Pregnancy Contraception: IUD Medical Termination of Pregnancy
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How to fill out use of secondary contraception
How to fill out use of secondary contraception
01
Consult with a healthcare provider to determine the most suitable form of secondary contraception.
02
Follow the instructions provided on how to properly use the chosen secondary contraception method.
03
Make sure to use secondary contraception consistently and correctly to ensure effectiveness.
04
Stay informed about any potential side effects or interactions with other medications.
Who needs use of secondary contraception?
01
Individuals who are at risk of unintended pregnancy despite using primary contraception methods like condoms or birth control pills.
02
People who are looking for an additional layer of protection against pregnancy.
03
Those who have experienced contraceptive failure in the past and want to minimize the risk of it happening again.
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What is use of secondary contraception?
Use of secondary contraception is a backup method used in addition to primary contraception to further prevent unwanted pregnancies.
Who is required to file use of secondary contraception?
Individuals who are using secondary contraception in addition to primary contraception are required to report its use.
How to fill out use of secondary contraception?
The use of secondary contraception can be filled out by providing details such as the type of secondary contraception being used and the frequency of use.
What is the purpose of use of secondary contraception?
The purpose of use of secondary contraception is to enhance the effectiveness of primary contraception and reduce the chances of unplanned pregnancies.
What information must be reported on use of secondary contraception?
Information such as the type of secondary contraception, frequency of use, and any side effects experienced must be reported.
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