The following documents are available as Word documents (editable and printer-friendly) and in pdf format (non-editable and printer-friendly). Some are also in Spanish to distribute to your patients.

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MEDICATION ABORTION USING MIFEPRISTONE

• Guidelines
     — Mifepristone/Misoprostol Abortion Protocol
           Evidence-Based Protocol for Medication Abortion:
           Using Mifepristone and Misoprostol in a Primary Care Setting
     — Indications for Sonography for Medication Abortion
     — Protocol Comparison — FDA vs. Evidence-based
     — Medication Abortion Counseling Model
     — Counseling Model for Ambivalent Patients

• Patient Education Materials
     — Early Abortion Options
     — Emergency Contraception And Medication Abortion: What’s The Difference?
     — Medication Abortion After-Care Instructions (Buccal Miso)
     — Medication Abortion After-Care Instructions (Vaginal Miso)
     — Your Birth Control Choices

• Forms
     — Documentation of Ultrasound Form
     — Updated Consent for an Early Medication Abortion
     — Medication Abortion Charting Form
     — Medication Abortion Chart Review Form
     — Mifepristone Log
     — Provider Packet
          - Early Abortion Options
          - Updated Consent for an Early Medication Abortion
          - Medication Abortion After-Care Instructions (Buccal Miso)
          - Medication Abortion After-Care Instructions (Vaginal Miso)
          - Documentation of Ultrasound Form
     — Mifepristone Patient Agreement English
     — Mifepristone Patient Agreement Spanish
     — Mifepristone Medication Guide English
     — Mifepristone Medication Guide Spanish

Training Resources for Medication Abortion
     — Role-play Script for Training in Administration of Medication Abortion

• Administrative/Other
     — Coding for Medication Abortion
     — Delineation of Privileges in Ultrasonography for Medication Abortions
     — Mifepristone Ordering Information
     — Patient Satisfaction Survey
     — Title X/330 issues
          - Administrative Billing Guide For Medical Abortion At Facilities That
            Receive Title X, Section 330, And Other Federal Funding

          - NFPRHA Bulletin on Efforts to Impose Restrictions on Title X Clinics
            that offer Abortion Services

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MEDICATION ABORTION USING METHOTREXATE/MISOPROSTOL

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MEDICATION ABORTION USING MISOPROSTOL ALONE

 

These forms are not intended to provide legal, medical or other professional advice. They are not a substitute for consultation with a healthcare provider or for independent judgment by healthcare providers or other professionals regarding individual conditions and situations.