Reproductive Health Services & Supplies

This page has resources and tools for providing medical services under the RH Program. Click the jump links below to get to specific sections of the page:

Purchasing Contraceptives
RH Program-Specific Resources
Screening Tools and Sample Health History Forms
Consent Forms (right column)

Purchasing Contraceptives

RHCare and CCare clinics are required to dispense a broad range of contraceptive methods on site at the time of the client’s visit. This resource is a list of vendors and distributors of contraceptives.

Where to Purchase Contraceptives

RH Program-Specific Resources

Charting Guidance

Moved to Billing page

STI Services

Moved to Billing page

Pregnancy Options Brochures

The RH Program requires that clients with positive pregnancy tests be provided neutral, factual information and nondirective counseling on prenatal care, adoption, and abortion, per the client’s desire. Clients must also be offered written information that includes contact information for agencies that give medically-accurate, unbiased information about the option(s) for which they are being listed.

To ensure this information is available to all clients, we created the below brochure in three different formats, Word, Adobe, and a format that can be opened using a web browser. The brochures are partially editable, so you can personalize them to include resources from your community.

Please see our Editing and Printing Instructions to determine which version is best for you.

English Word version | English Adobe version | English Non-Adobe version

Spanish (please note this is a previous version of the brochure, we are currently working to translate the new brochure)

Contracting with a Local Vasectomy Provider

Agencies that do not provide vasectomies on-site may contract with an external vasectomy provider.

For more information please see the resources below.

Contracting with an External Vasectomy Provider

Federal Consent for Sterilization Form (pdf) -

English | English Large Print

Spanish | Spanish Large Print

Sample Health History Forms

Providers should review a client's health history at the initial visit, and at least annually thereafter. Registered Nurses are permitted through the Board of Pharmacy’s CHC license to dispense birth control methods through standing orders. To ensure the necessary information is available for RNs to assess an individual’s health history, the RH program developed sample Initial Health History and Annual Health History forms.

Initial Health History	English	Spanish
Annual Health History	English	Spanish

Consent Forms

Consent for RH Services

Upon establishing care, clients/enrollee's must sign a consent form for reproductive health services. The consent may be incorporated into the clinic's general consent for services, or it may be a stand alone form. To help clinics meet this requirement, we created the following sample consent forms.

English	Spanish
Korean	Marshallese
Russian	Simplified Chinese
Vietnamese

Consent for Insertions and Removals

RHCare clinics are required to obtain consent from clients before they undergo a medical procedure (i.e. insertion / removal of an IUC or implant). To help clinics meet this requirement, we created these sample consent forms. Clinics may also use the consent form included in each devices' packaging. Either option is acceptable.

IUC Consent Form	English	Spanish
Implant Consent Form	English	Spanish