Get Ie Irish College Of General Practitioners Counselling Form - Iucd 2011-2025

Completing the IE Irish College Of General Practitioners Counselling Form - IUCD online is a straightforward process that can help you ensure that all necessary information is accurately provided. This guide will walk you through each step to facilitate a smooth experience as you fill out the form.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the counselling form and open it in your preferred editing tool.
2. Enter your full name in the designated field. Ensure that your name is spelled correctly as it will be used for identification.
3. Fill in your date of birth in the format D.O.B. (dd/mm/yyyy). This information is essential for verifying your identity and age.
4. Provide the date of your last menstrual period (LMP) in the specified format (dd/mm/yyyy). This helps in assessing your reproductive health.
5. List the name and contact information of your general practitioner (GP) in the relevant section.
6. Indicate your current contraception method by selecting from the options provided.
7. Record the date of your last sexual intercourse for reference.
8. Document your obstetric history, detailing the number of pregnancies and modes of delivery.
9. Note if you have any history of ectopic pregnancies.
10. Provide details in the gynaecological history section, including any previous pelvic infections, surgeries to the cervix, and the date of your last smear test.
11. If applicable, note any irregular vaginal bleeding that you may have experienced.
12. Complete the medical history section, specifying any acute liver disease or breast cancer history.
13. Discuss the mode of action of the IUCD with your healthcare provider and ensure that the associated risks and side effects, such as irregular bleeding, expulsion, and risk of infection are explained.
14. Conclude the consultation by indicating whether STI risk was discussed and if swabs were taken along with the date.
15. Select whether a leaflet with information was given to you. Respond with ‘Yes’ or ‘No’.
16. Provide your consent for the fitting of the IUCD by signing in the designated area or confirming your agreement.
17. Assess any further information or test results required, such as chlamydia testing, and document the date.
18. Once all fields are completed, save your changes. You can download, print, or share the form as needed.

Complete your IE Irish College Of General Practitioners Counselling Form - IUCD online today to ensure you have all the necessary information ready.