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Intrauterine Contraception Fitting Form

We are keen to make your clinic visit as straightforward and streamlined as possible.  It is important that you have read all the information and are suitable for the procedure on the day you come. You can also discuss other methods with us as well and ask any questions.

Please watch the Information About Intrauterine Contraception video for information about the IUD.

Intrauterine Contraception Fitting Form
Please tick the boxes to confirm that you have understood and agreed to the following:

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All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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