Preventing Unplanned Pregnancy and Completing College

LESSON THREE: Make a Plan and Take Action	

Birth Control Action Plan Worksheet

Step

Checklist 	
Action	
Resources
(Additional information/ suggested resources)	
Target 
date	
1.		Determine my preferred birth control method(s).  Write it (or them) here:

	Completed Lesson Three Study Guide		
2.		Prepare to talk to my partner about birth control.  Write a list of questions and statements I plan to discuss:

	Completed Lesson Three Study Guide		
3.		Determine how I can obtain my preferred birth control method(s): healthcare provider and/or over-the-counter. Write it here:

	Completed Lesson Three Study Guide		
4.		If I have health insurance, determine if my health insurance plan covers my preferred birth control method (answer yes or no):
	•	Completed Lesson Three Study Guide 
•	Health insurance plan website
•	My employer, spouse’s employer, or parents’ employer
		
5.		If I don’t have health insurance, do I qualify for free birth control?  If so, where can I obtain it?

	Completed Lesson Three Study Guide		
6.		What is the approximate cost of my preferred birth control method(s)?

	•	Completed Lesson Three Study Guide 
•	On-campus clinic or other healthcare provider
•	Pharmacist or drugstore
•	Health insurance provider
		
7.		Does my college have a health center on campus, and does it provide my birth control method(s)?

	•	Completed Lesson Three Study Guide		
8.		If I need to see a healthcare provider off-campus to obtain my preferred method, write the name, address, and phone number of the doctor or healthcare provider I want to see.

	•	Completed Lesson Three Study Guide 
•	Ask a friend or family member		
9.		If I need to see a healthcare provider, call and make an appointment.  Go to Bedsider to set up a reminder and write my appointment date here:

	www.bedsider.org/reminders		
10.		Prepare to talk to my healthcare provider about birth control.  Write a list of questions and statements I plan to discuss:

	Completed Lesson Three Study Guide		
11.		If I chose an over-the-counter birth control method, write where I plan to purchase it:

	•	Completed Lesson Three Study Guide 
•	Bedsider’s “Getting Birth Control Over-the-Counter” article
		
12.		If I receive a prescription for my birth control, write where I plan to fill it:
	•	Ask your doctor
•	Bedsider’s “How to Get a Prescription Filled” article
		
13.		Go to Bedsider website and set up reminders such as periodic shots, patch changes, doctors appointments, prescription refills, etc.	www.bedsider.org/reminders  
		
14.		Identify where I can obtain emergency contraception if I should need it.  Write it here:

	•	Completed Lesson Three Study Guide
•	http://bedsider.org/where_to_get_it 		
15.		Stay informed.  What resources on the right will you use to stay informed?

	Become a Bedsider Insider at
Bedsider.org/Insider.

Bedsider
•	Bedsider.org
•	On Facebook
•	On Twitter (@Bedsider)

Other Websites
•	www.StudentSexLife.org
•	www.TheNationalCampaign.org
•	test.sfsi.org/
•	www.ItsYourSexLife.com
		
16.		Other: