№ files_lp_4_process_3_120576
Form for recording monthly claims for emergency hormonal contraception consultations, including patient demographics, medications supplied, consultation outcomes, referral sources, and fees claimed.
Note: Year
Document Type: Medical claim form
Organization: PHARMACY FIRST
Target Audience: Pharmacists
Patient Age Groups: 13, 14, 15, 16 or >16
Medications Provided: UPA-EC, LNG-EC, Desogestrel x 3 months bridging POP
Referral Sources: GP, OOH, GUM, SH Clinic, Gateway
Consultation Outcomes: EHC, POP
Consultation Fees: £25, £15
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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