Rhode Island Title X Family Planning Program

• Family Planning Encounter Record
• FPER Instruction Sheet for Completing the FPER Form and what is a FP client
• WHSRP Care Questionnaire
• WHSRP Instruction Sheet for Completing the Care Questionnaire
• WHSRP Payment Request Form
• HIV CTR Form
• HIV Instruction Sheet for Completing the HIV CTR Form
• HIV Payment Request Forms for Rapid Testing and Standard Testing
  • HIV Payment Request Rapid Testing
  • HIV Payment Request Standard Testing
• Sterilization
• Consent Forms
  • Method Specific Consent Form English | Spanish
  • Sterilization
  • Emergency Contraception
  • Birth Control – General
  • Birth Control Without Exam
  • Combined Birth Control Pills
  • Progestin Only Pills
  • Minipill
  • IUD
• Copper
• Mirena
• Diaphragm
• Patch
• Ring
• Cervical Cap
• Sponge
• Materials Order Form

For more information on Family Planning or any of the services offered, please call HEALTH INFORMATION LINE 1-800-942-7434