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California State Board of Pharmacy

Self-Administered Hormonal Contraception Protocol Information

Protocol for Pharmacists to Furnish Self-Administered Hormonal Contraception

Patient-Self-Screening Tool

The patient must be asked to complete the self-screening tool to identify patient risk factors before the pharmacist initiates discussing self-administered hormonal contraception.

Comprehensive Birth Control Guide and Administration Specific Factsheet

http://www.fda.gov/downloads/ForConsumers/ByAudience/ForWomen/FreePublications/UCM517406.pdf

Patient Education Leaflet

The pharmacist must provide a patient education leaflet for the specific contraception provided to a patient on the appropriate method for using the drug, the need for medical follow up, and other appropriate information.