Contraception

Template

Contraception, follow-up

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Confidential interviewChoose any

ReviewedChoose any

Pregnancy riskChoose any

Current methodChoose one

EligibilityChoose any

SatisfactionChoose one

Bleeding patternChoose one

WeightChoose one

Blood pressureChoose oneNot in the note with these choices

InjectionChoose one

Pregnancy testChoose one

PlanChoose one

SupplyChoose anyNot in the note with these choices

Missed dosesChoose anyNot in the note with these choices

IUDChoose anyNot in the note with these choices

ImplantChoose anyNot in the note with these choices

Bone healthChoose anyNot in the note with these choices

CounselingChoose any

Follow-upChoose one

Counseling paragraphChoose oneParagraph

Note when inserted as is

Contraception, follow-up
• Confidential time with the adolescent, with the limits of confidentiality reviewed
• Adherence, side effects, and satisfaction with the method reviewed
• Follow up in 1 year

The office is available any time for side effects, a change of method, or questions between checkups. Return precautions given including severe belly pain, leg pain or swelling, chest pain, a severe headache or vision changes, fever with pelvic pain, feeling the IUD or not feeling its strings, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Patient expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Adherence, side effects, satisfaction reviewed
Current method (copper and levonorgestrel IUD separate)
Eligibility changes (US MEC)
Satisfaction; switch
Bleeding pattern and its management
Weight; blood pressure for combined methods (shown only for pill, patch, ring)
Depo timing (15-week window) and late-injection rules
Full-year supply, missed doses (pills, patch, ring), IUD strings, implant check, bone health (Depo)
Condoms, EC, STI testing offered or sent

Return precautions in the template

severe belly painleg pain or swellingchest paina severe headache or vision changesfever with pelvic painfeeling the IUD or not feeling its strings

Sources

The Cribsiders: #41, Dyslipidemia with Dr. Stephen Daniels (December 22, 2021)
Cribsiders show notes: #158 Plan A, B and C: Contraception (November 5, 2025)
Contraceptive Counseling and Methods for Adolescents: Clinical Report. Pediatrics 2025;156(1):e2025072218. (current; companion to policy)
Contraception for Adolescents: Policy Statement. Pediatrics 2025;156(1):e2025072217
Emergency Contraception. Policy Statement. Pediatrics 2019;144(6):e20193149. (cited as current by 2025 CR)