CONTRACEPTIVES AVAILABLE FOR PURCHASE
AT
ORAL CONTRACEPTIVE PILLS - current exam, prescription, RN appointment required. We currently stock Solia, Cryselle, Sprintec, Tri-Sprintec, Nortrel 1-35 and Aviane
COST: $15.00/CYCLE
ON-LINE REQUEST FOR PURCHASE IS AVAILABLE
*****Ensure you have adequate supply for break times when clinic
services are limited*****
DEPO-PROVERA INJECTION-current exam, prescription, RN appointment required
COST: $25.00/INJECTION
First Depo Injection (never used or restarting):
·
Injection
must be given within 5-days of period start
Repeat Depo Injection if previous injection was at another
clinic & you have current prescription:
·
Bring
written proof of last injection date
·
Get Depo
injection on time. Evaluation & lab work required if last
injection was +91 days ago
When you have current prescription
for Depo at
Make RN appointment for Depo injection (allow minimum of one
week to obtain appointment)
Find out what information you need to take to Depo injection
appointment.
Depending on your clinic’s requirements you may:
·
Purchase
Depo-Provera vial with prescription for administration &
statement of injection due date
·
Pick-up
written prescription from UW-L provider who prescribed your
Depo-Provera; or
·
Sign release
of information form for results of last exam and Depo
prescription
Remember: Five working days
are needed for medical records
EMERGENCY CONTRACEPTIVE PILLS (ECP/MORNING-AFTER PILL)
COST: $15.00
Available through RN appointment or urgent care. Effectiveness improved by taking as soon as possible after unprotected intercourse; it may be taken up to 120 hours after contact.
ECP is not considered a method of routine birth control.
CONDOMS – No prescription is required COST: $2.00/DOZEN
DIAPHRAGM – provider appointment required for diaphragm fitting; prescription written
OTHER METHODS – make a provider appointment to discuss other contraceptive methods
Purchasing Contraceptives
at UW-L Student Health Center
Emergency Service-a one time emergency refill of oral contraceptives, ring or Depo-Provera can be provided. For oral contraceptives or ring, evidence of current prescription is necessary. For Depo-Provera, must have verification of last injection date while medical records are being obtained.
Or
Original written prescription from health care provider for contraceptive method we stock. We can not accept phoned-in prescriptions or pharmacy labels. If you want your health care provider to fax a prescription, our clinic fax number is (608) 785-8746. Ask them to include you birth date on the prescription.
Or
Complete a release of medical
information form for
transfer of your contraceptive prescription records (annual
exam, Pap, and number of refills remaining) to us.
Come to the
Or
Make an appointment for an annual exam and contraceptive prescription by calling (608) 785-8558. If you have never used contraceptives or are changing methods, state that you need an initial exam or gyn double exam to allow for contraceptive options discussion and education.
PAYMENT:
For your
convenience, all charges incurred at the
Family Planning Waiver Program (FORWARD-Card)-This
program provides FREE birth control to eligible Wisconsin Women.
Applications are available at
the