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    Target Client List For Family Planning

    Uploaded by

    Gwendareign Elizan
    This document appears to be a template for tracking family planning clients. It includes columns for registration date, family serial number, name, address, age/birthdate, type of client, previous method, and follow up visit dates. The bottom section provides codes for reasons a client may drop out of the program such as becoming pregnant, wanting to become pregnant, medical complications, fear of side effects, or no longer being eligible for a particular method.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Target Client List For Family Planning

    Uploaded by

    Gwendareign Elizan
    413 views3 pages
    This document appears to be a template for tracking family planning clients. It includes columns for registration date, family serial number, name, address, age/birthdate, type of client, previous method, and follow up visit dates. The bottom section provides codes for reasons a client may drop out of the program such as becoming pregnant, wanting to become pregnant, medical complications, fear of side effects, or no longer being eligible for a particular method.

    Original Description:

    fp tcl forms

    Original Title

    FP FORMS

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    This document appears to be a template for tracking family planning clients. It includes columns for registration date, family serial number, name, address, age/birthdate, type of client, previous method, and follow up visit dates. The bottom section provides codes for reasons a client may drop out of the program such as becoming pregnant, wanting to become pregnant, medical complications, fear of side effects, or no longer being eligible for a particular method.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    413 views3 pages

    Target Client List For Family Planning

    Uploaded by

    Gwendareign Elizan
    This document appears to be a template for tracking family planning clients. It includes columns for registration date, family serial number, name, address, age/birthdate, type of client, previous method, and follow up visit dates. The bottom section provides codes for reasons a client may drop out of the program such as becoming pregnant, wanting to become pregnant, medical complications, fear of side effects, or no longer being eligible for a particular method.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    TARGET CLIENT LIST FOR FAMILY PLANNING

    DMPA (INJECTIBLES)
    PUT A NAME OF FP
    METHOD
    DATE OF FAMILY SERIAL NAME ADDRESS AGE/ BIRTHDATE TYPE OF CLIENT PREVIOUS METHOD
    REGISTRATION NUMBER 3 4 5 6 7
    MM/DD/YY 2
    1

    *TYPE OF CLIENT: CU= current users *PREVIOUS METHOD:


    NA= new acceptors CON= condom NFP-BBT= basal body
    temperature SDM= standard days method
    Other acceptors: INJ= DMPAN or CIC NFP-CM= cervical
    mucus method MSTR/VASECTOMY= male ster./vasectomy
    *CU-CM= changing method IUD= Intrauterine device (PP-IUD and I-IUD) NFP-STM= Sympothermal
    method FSTR/BTL= female ster./bilateral tubal ligation
    *CU-CC= changing clinic PILLS= pills NFP-LAM= lactation
    amenorrhea method
    *CU-RS= restarter IMP= single rod sub-thermal implant
    TARGET CLIENT LIST FOR FAMILY PLANNING
    None or NEW ACCEPTORS

    FOLLOW-UP VISITS DROP-OUT Remark


    (Upper Space: Next Service Date/ Lower Space: Date Accomplished) s or
    8 9 Action
    Taken
    10
    1ST 2ND 3RD 4TH 5TH 6TH 7TH 8TH 9TH 10TH 11TH 12TH DATE REASO
    N

    REASONS:
    A= Pregnant G= Menopause M= Underwent Bilateral Salpingo-oophorectomy For
    LAM:
    B= Desire to become Pregnant H= Lost or Moved out of the Area/Residence N= No FP Commodity A= Mother
    has a Menstruation or not ammenorhei
    C= medical complications I= Failed to get supply O= Unknown
    within 6 months or
    TARGET CLIENT LIST FOR FAMILY PLANNING
    D= fear of side Effects J= IUD expelled P= Age Out for BTL B= No longer
    practicing fully/ exclusively breastfeeding
    E= Change clinic K= Change Method or
    F= Husband Disapproves L= Underwent Hysterectomy C= Baby is more than 6
    months

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