Supporting Documentation Service Emergency Hormonal – Contraception Date Age of Ward of Pharmacist Consultation Time of Time of Pregnancy Levonelle Condoms client residence of Initials Y/N adminstration adminstration Test Y/N Administered provided Y/N client within 72 hour Y/N window
Supporting Documentation – Service Emergency Hormonal Contraception Date Age of client Ward of residence of client Pharmacist Initials Consultation Y/N Time of adminstration Time of adminstration within 72 hour window Pregnancy Test Y/N Levonelle Administered Y/N Condoms provided Y/N
Pharmacy-EHC-18-19.docx