Mirena iud patient consent pdf

    • Shared Care Protocol - NHS Wales

      to use either a barrier method or non-medicated IUD, alternatives are; increasing the dose of oestrogen in a combined pill, injections of some progestogens or a medicated IUD such as Mirena. ... To confirm the patient’s understanding and consent to treatment.

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    • [DOCX File]Contraception

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_d98c2f.html

      Minors may obtain or refuse birth control services at any age without the consent of a parent or guardian.

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    • [DOCX File]INTRAUTERINE DEVICE (IUD): IDENTIFICATION OF CANDIDATE

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_642021.html

      The Copper T380A IUD (ParaGard) is effective for at least 10 years.* In typical use, the copper IUD has a first year failure rate of 0.8%; its 10 year cumulative failure rate is 2.7%. The levonorgestrel-releasing IUS-20 mcg/24hr. (Mirena) is effective for 5 years and has a first year and 5 …

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    • [DOCX File]UW Obstetrics and Gynecology - Homepage

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_27fc29.html

      The patient was counseled on long-term contraceptive options. We discussed the use of Depo-Provera injections and permanent sterilization with either tubal ligation or Essure placement. We discussed Implanon and the ParaGard and Mirena IUDs. After discussion of the risks and benefits of each, the patient has elected {IUD TYPE:11675}.

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    • [DOC File]Federally Qualified Health Center Section II

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_b587b6.html

      By signing the Sterilization Consent Form DMS-615, the patient certifies that she or he understands the entire process. 1. By signing the consent form, the person obtaining consent and the physician certify that, to the best of their knowledge, the patient is mentally competent to give informed consent. ... (IUD) J7298 FP Mirena (IUD) J7300 FP ...

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    • [DOCX File]Acknowledgements - Ministry of Health NZ

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_5ec932.html

      In New Zealand Aotearoa, available long acting contraception (LARC) includes subdermal LNG implants (like Jadelle®), Cu-IUD (like Choice Load 375, Choice TT380 short, Choice TT380 standard), and LNG-IUS (LNG-IUS 52mg or 13.5mg like Mirena® or Jaydess®). The …

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    • [DOCX File]IUD Insertion Chart Form

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_28a53a.html

      IUD risks and benefits discussed with patient and all questions were answered. Institutional . Procedure Consent . signed and placed in chart. Time out procedure performed. IUD selected: Cu T IUD (Paragard) Levonorgestrel IUS (Mirena) IUD Lot number: _____ Expiration date : _____ Procedure: Bimanual exam: No uterine tenderness.

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    • [DOCX File]INTRAUTERINE DEVICE (IUD): IDENTIFICATION OF CANDIDATE

      https://info.5y1.org/mirena-iud-patient-consent-pdf_1_1ea0e0.html

      See manufacturer’s website for additional copies of the patient brochure and the consent forms in her language. Consider advising patient to take a nonsteroidal anti-inflammatory agent 1 to 4 hours prior to IUD placement if not medically contraindicated. It will not reduce pain during IUD placement, but may reduce cramping and pain afterwards.

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