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Consent Request for CHC in Women with Special - FHA - fha dhmh maryland

Consent Request for CHC in Women with Special - FHA - fha dhmh maryland 2025

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The document is a consent form for women with special conditions or risk factors seeking hormonal contraceptives. It outlines the importance of understanding associated risks, particularly for those with specific health concerns such as age, tobacco use, hyperlipidemia, diabetes, and chronic hypertension. The client acknowledges receiving counseling and education about these risks and agrees to the prescription of combined hormonal contraceptives after discussing alternatives.

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