FamilyPlanningTasmaniaMTOPPatientEligibilityQuestionnaire

Before you answer this questionnaire to determine your suitability for medication termination of pregnancy (MTOP), please ensure that you have read the general information on our website regarding pregnancy choices, especially the section on MTOP.

There are a number of medical conditions and medications that might mean a MTOP is not suitable for you. This will be assessed at your first appointment and if required we can help you access other termination options.

Family Planning Tasmania has a limited capacity to provide MTOP. If we are not able to offer you a MTOP we can help you access other termination providers.

1. Certainty of decision Y/N

2. Have you had a positive pregnancy test? Y/ N

3. Do you think that you are under 8 weeks pregnant? Y/N

4. Do you have an Australian Medicare Card? Y/N

5. Do you have an adult support person who can be with you for several hours after you have taken the second dose of medication? Y/N

6. Will you be staying somewhere less than one hour from a public hospital after you have taken your second dose of medication? Y/N

7. Do you or your support person have a good understanding of English, sufficient to be able to confidently read and follow written medical instructions and be able to contact emergency care without the aid of an interpreter? Y/N

You must have answered YES to all of the above questions in order to make your first appointment for a MTOP with Family Planning Tasmania.

Please be aware that a medication termination MUST be completed before 9 weeks gestation. It may take several days from an initial appointment for have all the necessary investigations required.

If you are considering MTOP please make an early appointment and be aware that you must have a reliable method for Family Planning Tasmania to contact you by so we can discuss essential parts of your care during the MTOP pathway.

If you answered NO to any of the above questions, you can still make an appointment at Family Planning Tasmania to talk to one of our nurses about other options available to you.

If you are uncertain of your decision you can make an appointment at Family Planning Tasmania to talk to one of our nurses for non-directional counselling.
All of our services are completely confidential, respectful, and non-judgmental.

Family Planning Tasmania is a pro-choice organisation.

 

    What costs are involved for MTOP at Family Planning Tasmania?

    Financial support may be available for those:

    · under 25 years of age through the Youth Health Fund (YHF)

    · over 25 years of age and on a Centrelink concession card, through Women’s Health Tasmania Fund (WHF)

    If you are eligible for this financial support, Family Planning Tasmania Nurses will assist you to complete the application forms. There may be a small contribution required, or no out of pocket expense to you for this procedure.

    The doctor will talk to you about ongoing contraception options post MTOP and usual Family Planning Tasmania fees will be applicable for these consultations.

    All fees are payable on the day of consultation and no accounts are issued.

    MakeanAppointment
    Glenorchy
    9am-5pm Mon-Fri6273 9117
    Launceston
    9am-5pm Mon-Fri6343 4566
    Burnie
    9am-5pm Mon, Wed, Thurs6431 7692