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Home | Resources | Checklists for Screening Clients Who Want to Initiate Use of the LNG-IUS
December 12, 2016

Checklists for Screening Clients Who Want to Initiate Use of the LNG-IUS

January 2017 — The levonorgestrel intrauterine system (LNG-IUS) checklist consists of questions designed to rule out pregnancy and identify other medical conditions and high-risk behaviors that would prevent safe LNG-IUS use or require further screening. It also provides guidance and directions based on a client’s responses and a provider’s observations. The English, French and Spanish versions of the checklist reflect the latest medical eligibility criteria published in 2015 by the World Health Organization (WHO).

Checklists for Screening Clients Who Want to Initiate Combined Oral Contraceptives (COCs)

2015 — The combined oral contraceptives (COCs) checklist consists of questions designed to identify medical conditions that would prevent safe COC use or require further screening and assess whether a client might be pregnant. It also provides guidance and directions based on clients’ responses. The English, French and Spanish versions of the checklist reflect the latest medical eligibility criteria published in 2015 by the World Health Organization (WHO) and include guidance for providers whose clients may be eligible for emergency contraception. The checklist is also available in versions adapted for specific countries.

The checklist is also available in English and French as a mobile application designed to run on devices such as mobile phones, tablets and computers. It can be viewed on a computer or on any internet-enabled mobile device using Google Chrome, Safari or Microsoft Edge. To download the checklist as a native app on your phone or tablet, click on the link below and click on the “download” icon on your device. Once the app is downloaded, it can be accessed without an internet connection. To view or download the app in French, set the locale of your device to “France.”

Checklists for Screening Clients Who Want to Initiate Contraceptive Implants

2015 — The implants checklist consists of questions designed to identify medical conditions that would prevent safe implants use or require further screening and assess whether a client might be pregnant. It also provides guidance and directions based on clients’ responses. The English, French and Spanish versions of the checklist reflect the latest medical eligibility criteria published in 2015 by the World Health Organization (WHO) and include guidance for providers whose clients may be eligible for emergency contraception. The checklist is also available in versions adapted for specific countries.

The checklist is also available in English and French as a mobile application designed to run on devices such as mobile phones, tablets and computers. It can be viewed on a computer or on any internet-enabled mobile device using Google Chrome, Safari or Microsoft Edge. To download the checklist as a native app on your phone or tablet, click on the link below and click on the “download” icon on your device. Once the app is downloaded, it can be accessed without an internet connection. To view or download the app in French, set the locale of your device to “France.”

Checklists for Screening Clients Who Want to Initiate DMPA (or NET-EN)

2015 — The DMPA/NET-EN checklist consists of questions designed to identify medical conditions that would prevent safe DMPA/NET-EN use or require further screening and assess whether a client might be pregnant. It also provides guidance and directions based on clients’ responses. The English, French and Spanish versions of the checklist reflect the latest medical eligibility criteria published in 2015 and the guidance statement issued in 2017 by the World Health Organization (WHO) and include guidance for providers whose clients may be eligible for emergency contraception. The checklist is also available in versions adapted for specific countries.

The checklist is also available in English and French as a mobile application designed to run on devices such as mobile phones, tablets and computers. It can be viewed on a computer or on any internet-enabled mobile device using Google Chrome, Safari or Microsoft Edge. To download the checklist as a native app on your phone or tablet, click on the link below and click on the “download” icon on your device. Once the app is downloaded, it can be accessed without an internet connection. To view or download the app in French, set the locale of your device to “France.”

Checklists for Screening Clients Who Want to Initiate Use of the Copper IUD

2015 — The intrauterine device (IUD) checklist consists of questions designed to rule out pregnancy and identify other medical conditions and high-risk behaviors that would prevent safe IUD use or require further screening. It also provides guidance and directions based on clients’ responses. The English, French and Spanish versions of the checklist reflect the latest medical eligibility criteria published in 2015 by the World Health Organization (WHO) and include guidance for providers whose clients may be eligible for emergency contraception. The checklist is also available in versions adapted for specific countries.

The checklist is also available in English and French as a mobile application designed to run on devices such as mobile phones, tablets and computers. It can be viewed on a computer or on any internet-enabled mobile device using Google Chrome, Safari or Microsoft Edge. To download the checklist as a native app on your phone or tablet, click on the link below and click on the “download” icon on your device. Once the app is downloaded, it can be accessed without an internet connection. To view or download the app in French, set the locale of your device to “France.”

Documents / Downloads

  • Checklists for Screening Clients Who Want to Initiate Use of the LNG-IUS (English)
  • Checklists for Screening Clients Who Want to Initiate Use of the LNG-IUS (French)
  • Checklists for Screening Clients Who Want to Initiate Use of the LNG-IUS (Spanish)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (English)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (French)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (Spanish)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (Kenya)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (Uganda)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (India in Hindi)
  • Checklist for Screening Clients Who Want to Initiate Combined Oral Contraceptives (Nigeria)
  • Checklist for Screening Clients Who Want to Initiate Contraceptive Implants (English)
  • Checklist for Screening Clients Who Want to Initiate Contraceptive Implants (French)
  • Checklist for Screening Clients Who Want to Initiate Contraceptive Implants (Spanish)
  • Checklist for Screening Clients Who Want to Initiate Contraceptive Implants (Kenya)
  • Checklist for Screening Clients Who Want to Initiate Contraceptive Implants (Nigeria)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (English)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (French)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (Spanish)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (Kenya)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (Uganda)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (India in Hindi)
  • Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN) (Nigeria)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (English)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (French)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (Spanish)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (Kenya)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (Uganda)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (India in Hindi)
  • Checklist for Screening Clients Who Want to Initiate Use of the Copper IUD (Nigeria)
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