FAMILY PLANNING


The following are revised, reaffirmed, renamed, or new and replace all previous versions.

April, 2017
 
CLINICAL GUIDELINES


 
Section IA:  General Reproductive and Family Planning Services

Required Services (See Administrative Guidelines)

 

Section IB:  Contraceptive Services

  1. Abstinence and Coitus Interruptus
  2. Combined Hormonal Contraceptives 
  3. Combined Hormonal Contraceptives Consent 
  4. Combined Hormonal Contraception Initiation Record 
  5. Combined Hormonal Contraceptives Client Education
  6. Consent  - Request for Combined Hormonal Contraception in Women with Special Risks 
  7. Combined Oral Contraceptives
  8. Combined Oral Contraceptives Client Education
  9. Combined Oral Contraceptives Consent
  10. Depot-Medroxyprogesterone Acetate (DMPA)
  11. Depot-Medroxyprogesterone Acetate (DMPA) Client Education
  12. Depot-Medroxyprogesterone Acetate (DMPA) Consent
  13. Diaphragm
  14. Diaphragm Client Education
  15. Diaphragm Consent
  16. Emergency Contraception (ECP)
  17. Emergency Contraception (ECP) Client Education
  18. Emergency Contraception (ECP) Initiation Record
  19. Intrauterine Contraception (IUD) 
  20. Intrauterine Contraception (IUD) Client Education
  21. Intrauterine Contraception (IUD) Consent
  22. Lactational Amenorrhea and Other Natural Family Planning Methods
  23. Non-prescription Barrier Methods and Spermicides
  24. Progestin-Only Oral Contraception
  25. Progestin-Only Oral Contraception Consent
  26. Sterilization
  27. Subdermal Contraceptive Implant  
  28. Subdermal Contraceptive Implant Client Education
  29. Subdermal Contraceptive Implant Insertion Record 
  30. Subdermal Contraceptive Implant Removal Record 
  31. Subdermal Contraceptive Implant Insertion Consent
  32. Subdermal Contraceptive Implant Removal Consent
  33. Transdermal Contraceptive Patch 
  34. Transdermal Contraceptive Patch Consent
  35. Vaginal Contraceptive Ring 
  36. Vaginal Contraceptive Ring Consent

 

Section IIA:  Sexually Transmitted Infection Screening and Treatment Guidelines

  1. Bacterial Vaginosis 
  2. Chlamydia  
  3. Gonorrhea 
  4. Hepatitis B (HBV) 
  5. Hepatitis C (HCV) 
  6. HPV and HPV Vaccination
  7. Herpes Simplex Virus (HSV) 
  8. Human Immunodeficiency Virus (HIV) 
  9. Syphilis 
  10. Trichomoniasis 
  11. Urinary Tract Infection 
  12. Vulvovaginal Candidiasis

 

Section IIB:  Gynecologic Services/Health Promotion and Disease Prevention


 

Section III:  Primary Care and Preventative Services

  1. Anemia
  2. Diabetes Screening
  3. Dyslipedemia 
  4. Hypertension
  5. Substance Abuse


 

CONSENTS - SPANISH

  1. Depot Medroxy Progesterone Acetate
  2. Diaphragm 
  3. Emergency Contraception
  4. Individualized Contact Plan for Family Planning 
  5. Intrauterine Contraception 
  6. Norplant Removal 
  7. Oral Contraceptive Methods 
  8. Request for CHC in Women with Special Risk 
  9. Subdermal Contraceptive Implant 
  10. Transdermal Contraceptive Patch 
  11. Vaginal Contraceptive Ring 

 

Quality Assurance Program Review Tools


 


Supporting Documents

U.S. Medical Eligibility Criteria for Contraceptive Use, 2016

STD Treatment Guidelines

ADMINISTRATIVE GUIDELINES

Click here to view a copy of the Maryland State Family Planning Program Administrative Guidelines for 2017 which help delegate agencies in implementing programmatic policies and procedures that are in compliance with State requirements and the Title X Program Guidelines for Project Grants for Family Planning Services, issued by the Office of Population Affairs, U. S. Department of Health and Human Services, January 2001.

RELATED DOCUMENTS
   Cytology Algorithm
   CDC STD Treatment Guidelines
   Reportable Diseases 

Questions regarding Maryland's Clinical and Administrative Guidelines can be sent to mdh.mchb@maryland.gov.  Please enter 'guidelines' in the subject line.
 

TITLE X TRAINING

Click here for the Family Planning National Training Center training and resources. 
 
Please record each completed training with the Maryland Family Planning Program by clicking here.

 
 
FAMILY PLANNING LINKS AND FORMS

Client Survey - English
Client Survey - Spanish
AccessMatters (formerly Family Planning Council)
Community Health Education Annual Report 
Community Participation, Education, and Project Promotion
Family Planning Clinic Sites
Family Planning - A Guide For You - English 2017.pdf 
Family Planning - A Guide For You - Spanish 2015.pdf 
HIPAA - Individual's Authorization 
Informational & Educational Material Review - Evaluation Worksheet
Informational & Educational Material Review - Evaluation -Electronic vers.
Methods of Birth Control
Reproductive Health Update 2015 Presentations