In 2023, the North Dakota family planning clinics saw over 4,300 unduplicated clients. A huge thank-you to the following clinics for your passion and commitment in serving and making a difference in so many lives:
Central Valley Health District
Custer Family Planning - UND Center for Family Medicine
Fargo Cass Public Health
First District Health Unit
Lake Region District Health Unit
MyAlly Health
Richland County Health Department
Upper Missouri District Health Unit
Family planning grantees please refer to the links below for Policies/Protocols/Forms, Publications, and References.
For more information, contact the Family Planning Program at 701.328.2228
Policies, Protocols and Forms
Policies
2 Project Services and Clients
2.10 Pregnancy Testing and Counseling
2.11 Compliance with Legislative Mandates
2.3 Non-Discriminatory Services
2.4 Availability of Social Services
2.5 Availability and Use of Referrals
2.6 Clinical Protocols and Standards of Care
2.7 Provision of Family Planning and Related Services
2.7.1 Comprehensive Health History
2.7.12 Dispensing Pharmaceuticals
2.7.2 STI Testing and Treatment
2.7.3 Preconception Counseling
2.7.4 Basic Infertility Services
2.7.7. Recommended Screenings for Title X
2.7.8 Substance Abuse Screening
Protocols
CON 1 Quick Start Same Day Start Method
CON 2 Identification of the IUC Candidate
CON 5 Identification of a Hormonal Implant Candidate
CON 6 Hormonal Implant Removal
CON 7 Progestin-only Contraceptives: Persistent Bleeding
CON 9 Extended Combined Contraceptives
CON 10 Progestin Only Contraceptive (POCs)
Forms
Consent for Family Planning Services
Consent for Family Planning Services (Nepalese)
Consent for Family Planning Services (Somali)
Consent for Family Planning Services (Spanish)
Consent for Family Planning Services (Ukrainian)
Consent for Hormonal Implant (Nepalese)
Consent for Hormonal Implant (Somali)
Consent for Hormonal Implant (Spanish)
Consent for Hormonal Implant (Ukrainian)
Consent for IUC (Nepalese)
Consent for IUC (Somali)
Consent for IUC (Spanish)
Consent for IUC (Ukrainian)
Instructions for Mini pill (Progestin-Only Pills)
Instructions on Combined Oral Contraceptives (ADA Compliant)
Instructions on Contraceptive Transdermal Patch
Instructions on Contraceptive Vaginal Ring
Instructions on Emergency Contraceptive Pills
Instructions on Natural Family Planning (Fertility awareness-based method)
Chart Review Form and Guidelines
Client Satisfaction Survey (Fillable PDF version)
Family Planning Statement of Understanding
IMA Tool and Guidelines - SFN 59320
Interagency Client Medical Information Sheet (SFN 59154)
Medical Record Release (SFN 51939)
Medication Profile (SFN 08627)
Midlevel Practitioner Staffing Profile
Referral for Medical and Social Services (SFN 08624)
Refusal to Accept Referral/Follow-up (SFN 59153)