EHC Medical Assessment

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Contact Details

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About You

Are you over 16 years old?(Required)

Yes

The minimum age for the service is 16 years old.
If you're under 16 years old, contact your GP or local sexual health clinic.

Date of Birth(Required)

Day

Month

Year

How much do you weigh?

If you weigh over 85 Kg (13 stones), or your BMI is over 30, neither pill will be effective.
We cannot provide you with free emergency hormonal contraception.
The copper coil is a better option for you.
Discuss this with your GP or sexual health clinic.

Contraception

What is the reason for your request?

If you ticked "Other" in the previous question, please briefly explain.

When did you have unprotected sex?

If you had unprotected sex more than 96 hours ago, you must collect in our Camberley store (GU15 2QN).

We cannot deliver free emergency hormonal contraception on time under these circumstances.

If you had unprotected sex more than 120 hours ago, you are not eligible for this service.

A better option would be the copper coil. Discuss this with your GP or sexual health clinic.

We cannot provide you with free emergency hormonal contraception.

Which contraception method are you using?

If you are using a method of contraception and need emergency contraception regularly, consider switching to long-lasting reversible contraceptives like coils or implants.(Required)

I have read the information

Pregnancy and Breastfeeding

Are you pregnant?(Required)

Yes

If you've had other episodes of unprotected sex since your last period and not used emergency contraception, you should take a pregnancy test before doing anything else.

We cannot provide you with free emergency hormonal contraception if you are pregnant.

Discuss this with your GP or sexual health clinic.

Have you given birth within the last 3 weeks?(Required)

Yes

If you have given birth within the last 21 days, your chances of getting pregnant are minimal and you don't need emergency contraception. This doesn't include terminations, abortions, or miscarriages.

I have read the information

Are you currently breastfeeding?(Required)

Yes

Within 72 hours of the intercourse, Levonorgestrel is the preferred choice as you can continue to breastfeed. Within 120 hours, ellaOne can be used but you should not breastfeed for 7 days as it gets in breastmilk. Express and discard your milk and use an alternative baby feed for seven days.(Required)

I have read the information

Medical History

In the past seven days, have you taken any of the following medications?(Required)

If you have used an emergency contraceptive pill in the last 7 days, you must take the same type of pill. EllaOne and Levonorgestrel interfere with each other if used within 7 days of each other.(Required)

I have read the information

If you have taken Norethisterone, Utovlan or Primolut N within the last 7 days, then Levonorgestrel is the preferred option. If it has been more than 72 hours since you had sex, contact your GP or local sexual health clinic to get a coil fitted. This does not apply if you have taken Provera, or if there are more than 7 days between the period delay medication and morning after pill.(Required)

I have read the information

Are you currently taking any of the following medications?(Required)

None of the below

Antibiotics

Metronidazole

Phenytoin

Carbamazepine

Griseofulvin

Modafinil

Orlistat

Oxcarbazepine

Phenytoin

Rifabutin

Eslicarbazepine

Rifampicin

Topiramate

Other Medication for Epilepsy

Ranitidine

Gaviscon

Lansoprazole

Omeprazole

Pantoprazole

Other Proton Pump Inhibitors

If you are using enzyme-inducing medications, these medications can reduce the effectiveness of oral emergency contraception. A Copper coil is the best way to provide emergency contraception in your case. You can get one fitted at your local sexual health clinic or ask your GP. If you are not getting a copper coil, we can offer you a double dose (3mg) of levonorgestrel, or a single dose (30mg) of EllaOne. However, we cannot guarantee whether it will be effective of not.(Required)

Enzyme-inducing medications are:
Phenytoin
Carbamazepine
Griseofulvin
Modafinil
Orlistat
Oxcarbazepine
Phenytoin
Rifabutin
Eslicarbazepine
Rifampicin
Topiramate

I have read the information

Do you have any allergies?(Required)

Yes

What are you allergic to?(Required)

Please list all the allergies you have.

Please tick to confirm that you have read the information below.(Required)

Pregnancy Test Requirement: Before using emergency contraception, take a pregnancy test if you've had unprotected sex since your last period without using emergency contraception.

Effectiveness Timing: The morning after pill (e.g., Levonorgestrel) should be taken as soon as possible, ideally within 12 hours but no later than 72 hours after unprotected sex, noting it's less effective in the middle of the menstrual cycle and not 100% guaranteed to prevent pregnancy.

Medical Advice and Reporting: Report any side effects to your healthcare provider and inform them if you start new medications or if your health conditions change during treatment. The medication is for your use only, based on the truthful information you provide.

Follow-up Actions: If vomiting occurs within 3 hours of taking the pill, take another dose immediately. Use barrier methods until your next period and continue any regular hormonal contraception as normal.

Health Monitoring: Seek immediate medical attention for unusual abdominal pain, and consult a healthcare professional for abnormal vaginal symptoms or concerns following emergency contraception use.

Menstrual Cycle Changes: Be prepared for possible disturbances in your menstrual cycle, including changes in the timing and nature of your next period. If your period is more than 5 days late, unusually light or heavy, take a pregnancy test and contact your GP.

Sexually Transmitted Diseases: Emergency contraception does not protect against STDs, highlighting the importance of using condoms for protection.

Future Contraception Planning: Emergency contraception is not a substitute for regular, long-term contraceptive methods. Consult with a healthcare provider for advice on reliable long-term contraception.

I have read the information

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Emergency Hormonal Contraception(Required)

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Next Working Day Delivery by 1PM +£ 6.99

Saturday Delivery by 1PM +£ 12.99

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EHC Medical Assessment

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Contact Details

About You

Contraception

Pregnancy and Breastfeeding

Medical History

Payment Details

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