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Contraceptive Implants - Form Download

DOWNLOAD: Contraceptive Implant Consent Form

This must be downloaded, printed, section 1 to be completed prior to the appointment by the patient.  You MUST bring this form with your to your appointment for the Dr to carry out the necessary procedure.   

Contraceptive Implants - Information

Over 99% effective.  An implant is a small, flexible rod placed under the skin.  Contains a progesterone only hormone which is slowly released into the body.  Each one lasts 3 years and is easily reversible.  Useful if you forget to take pills.

We are pleased to be able to offer a contraceptive implant fitting and removal service, and the following doctors carry out these procedures; 

  • Dr Francis
  • Dr Gillibrand
  • Dr Rahim
  • Dr Tabberer


If you are certain you would like an implant fitted we ask you that; Fits/Removals and refit

  1. Read the information www.sexwise.org.uk/contraception/contraceptive-implant 
  2. Consider the timing.  In order to be certain that you are not pregnant or at risk of pregnancy when we fit an implant, we can either fit the implant...
    • In the 5 days after the start of your period, OR 
    • At anytime if you have not had sex since your period started, OR
    • You have not had sex for 3 weeks if you rarely have periods and cannot predict them, OR
    • Any anytime if you have been reliably using another form or hormonal contraception (the pill, mini pill, IUD or injection)
  3. Tell reception the appointment is for an implant fit (or removal and fit) and we will try and find a time to suit you with one of the doctors above. The doctor will discuss the method with you before the procedure and check you are aware of all the possible side effects. 

If you are not certain and you would prefer to come in and talk about it first, then please make an appointment with either a doctors or a nurse in Clinic B. 

Removals

If you  have an implant that is due to be removed, or you wish to stop using the method as you would like to become pregnant you can simply book into a double appointment for this procedure.  You can have a further one inserted at the same time if you want to continue using the method. 

If you wish for removal for any other reason, for example you have been suffering from unacceptable side effects from an implant we would prefer that you make an appointment first preferably with a doctor who fits implants so they we can discuss the best management plant for you. 

 
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