(a) The licensed pharmacist shall provide the patient with an informed consent form, in accordance with form Ph EC-2, which may be obtained from the office of the board identified in Ph 103.03.(b) The informed consent form shall include at least the following:(1) The indications for use of emergency contraception;(2) The mechanism of action of the medication;(3) The appropriate method for taking the medication;(4) The possible reactions after taking the medication; and(5) The circumstances that may require follow-up with a physician.(c) After the patient has read, and/or reviewed with the licensed pharmacist, the statements specified on the informed consent form, both the patient and the licensed pharmacist shall sign and date the form.N.H. Admin. Code § Ph 1001.04
#8447, INTERIM, eff 10-14-05, EXPIRED: 4-12-06
New. #8708, eff 8-23-06
The amended version of this section by New Hampshire Register Volume 36, Number 45, eff. 10/22/2016 is not yet available.