FAMILY PLANNING PROGRAM INFORMED CONSENT FOR CONTRACEPTIVE METHODS (Prescription & Non-Prescription) ORAL CONTRACEPTIVES I have chosen oral contraceptives as my method of contraception. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of oral contraceptive use. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________
DEPO-PROVERA I have chosen Depo-Provera as my method of contraception. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of Depo-Provera. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________
NUVA RING I have choosen the Nuva Ring as my method of contraception, I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of Nuva Ring. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________
BARRIERS (Condoms, Foams, or Diaphragm) I have chosen to use a barrier as my method of contraception. I have been provided counseling and written information regarding the benefits, risks, effectiveness, potential side effects, and complications related to the use of this method. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________ INTRAUTERINE DEVICE (IUD) I have chosen the Intrauterine Device (IUD) as my method of contraception. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of the IUD. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________ IMPLANON I have chosen the Implanon as my method of contraception. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of the Implanon. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________
EMERGENCY CONTRACEPTION (PLAN B) I have requested Plan B for emergency contraceptive use. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of using Plan B. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________ ORTHO EVRA “The Patch” I have chosen Ortho Evra transdermal system as my method of contraception. I have been provided counseling and written information regarding the benefits and risks, effectiveness, potential side effects, complications, and danger signs of Ortho Evra transdermal system use. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________ NATURAL FAMILY PLANNING (CycleBeads) OR FERTILITY AWARENESS METHOD I have chosen to use Natural Family Planning for Fertility Awareness as my method of contraception. I have been provided counseling and written information regarding the benefits, risks, effectiveness and complications related to the use of this method. I have been given the opportunity to ask questions and I understand the information that has been provided to me. _________________________________
Letters in Applied Microbiology ISSN 0266-8254Modified nitrocefin-EDTA method to differentially quantifythe induced L1 and L2 b-lactamases in StenotrophomonasmaltophiliaR.-M. Hu1, K.-H. Chiang2, C.-W. Lin2 and T.-C. Yang21 Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan2 Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichu
Suggested citation for this article: Firstenberg MS, Blais D, Louis LB, Stevenson KB, Sun B, Mangino JE. Extracorporeal membrane oxygenation for pandemic (H1N1) 2009 [letter]. Emerg Infect Dis. 2009 Dec; [Epub ahead of print] To the Editor : As the world struggles with the challenges of influenza A pandemic (H1N1) 2009, it is clear that treatment options for critically ill infected patient