Implanon NXT checklist and consent form (PDF 51KB)
The doctor checklist and patient consent form for the insertion of IMPLANON® NXT has been developed by the RACGP's National Standing Committee - Quality Care and National Standing Committee - GP Advocacy & Support to assist General Practitioners maintain a high level of quality and safety in the insertion of IMPLANON® NXT .
The forms are designed for use in a three-stage process - an initial consultation followed by the insertion and removal of the implant. Medical Indemnity Insurers (MIIs) may have requirements regarding IMPLANON® NXT
Merck Sharp and Dohme (MSD) may have requirements for training in the insertion of this product. It is important to be aware of this and the need to complete appropriate training that meets the educational requirements prior to inserting IMPLANON® NXT.