Utah Code § 26B-4-506

Guidelines for dispensing a self-administered hormonal contraceptive
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(1) A pharmacist or pharmacist intern who dispenses a self-administered hormonal contraceptive
under Section 26B-4-504:

(a) shall obtain a completed self-screening risk assessment questionnaire, that has been
approved by the division in collaboration with the Board of Pharmacy and the Medical
Licensing Board, from the patient before dispensing the self-administered hormonal
contraceptive;
(b) if the results of the evaluation in Subsection (1)(a) indicate that it is unsafe to dispense a self-
administered hormonal contraceptive to a patient:
(i) may not dispense a self-administered hormonal contraceptive to the patient; and
(ii) shall refer the patient to a primary care or women's health care practitioner;
(c) may not continue to dispense a self-administered hormonal contraceptive to a patient for
more than 24 months after the date of the initial prescription without evidence that the patient
has consulted with a primary care or women's health care practitioner during the preceding 24
months; and
(d) shall provide the patient with:
(i) written information regarding:
(A) the importance of seeing the patient's primary care practitioner or women's health care
practitioner to obtain recommended tests and screening; and
(B) the effectiveness and availability of long-acting reversible contraceptives as an alternative
to self-administered hormonal contraceptives; and
(ii) a copy of the record of the encounter with the patient that includes:
(A) the patient's completed self-assessment tool; and
(B) a description of the contraceptives dispensed, or the basis for not dispensing a
contraceptive.
(2) If a pharmacist dispenses a self-administered hormonal contraceptive to a patient, the
pharmacist shall, at a minimum, provide patient counseling to the patient regarding:
(a) the appropriate administration and storage of the self-administered hormonal contraceptive;
(b) potential side effects and risks of the self-administered hormonal contraceptive;
(c) the need for backup contraception;
(d) when to seek emergency medical attention; and
(e) the risk of contracting a sexually transmitted infection or disease, and ways to reduce the risk
of contraction.
(3) The division, in collaboration with the Board of Pharmacy and the Medical Licensing Board,
shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
establishing the self-screening risk assessment questionnaire described in Subsection (1)(a).

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