SCAI Project Clinic Matching Form

Zip Code:

Do you require financial assistance?

Yes, please connect me to a clinic that offers financial assistance

Contraceptive Options:

Please select whichever contraceptive options you are comfortable with

If you are unsure which option would work best for you and your lifestyle, please select the "unsure" option.

Caps or Diaphragms
Combined Pill
Condoms
Contraceptive Implant
Contraceptive Injection
Contraceptive Patch
Female Condome
IUD (Inauterine Device or Coil)
IUS (Inauterine System or Hormonal Coil)
Progestogen-Only Pill
Vaginal Ring
Unsure