Signature Signature Signature Provides information to women and their partners O/E CD/CI CI regarding sexual health and Date Date Date contraception Signature Signature Signature Cares for women with O CD/CI CI restricted mobility Date Date Date Signature Signature Signature Educates women with regard E/CD CD/CI CI to perineal hygiene Date Date Date Signature beds whilst occupied CI and unoccupied Date Signature Signature Signature Provides post-operative care O CD/CI CI Date Date Date Signature Signature Signature *O CS/E
Provides information to women and their partners regarding sexual health and contraception O/E Signature CD/CI Signature CI Signature Date Date Date Cares for women with restricted mobility O Signature CD/CI Signature CI Signature Date Date Date Educates women with regard to perineal hygiene E/CD Signature CD/CI Signature CI Signature Date Date Date beds whilst occupied and unoccupied CI Signature Date Provides post-operative care O Signature CD/CI Signature CI Signature Date Date Date *O Signature CS/E Signature Signature