Phexxi Form What was your sex assigned at birth?
Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.
Are you currently pregnant or planning to become pregnant?
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Consent (pregnancy):
I understand that the medication prescribed to me by my healthcare provider may not be safe to take during pregnancy. I acknowledge that taking this medication while pregnant could pose risks to my health and the health of a developing fetus.
I agree to take necessary precautions to avoid becoming pregnant while using this medication, including the use of effective contraception methods as discussed with my healthcare provider.
I understand that I should stop taking this medication before attempting to become pregnant. I agree to consult with my healthcare provider prior to discontinuing the medication and before planning a pregnancy to ensure my safety and well-being.
By selecting below, I confirm that I have read and understand the information provided above. I consent to proceed with the treatment under these conditions.
Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.
Thank you for your interest in Phexxi. Lets get started to ensure that this product is right for you and to provide you information about how to best use this medication.
Do you plan to use Phexxi alone or together with another method?
Phexxi is a non-hormonal, vaginal contraceptive that is only used prior to intercourse. When used correctly, it is about 86% effective at preventing pregnancy. It is less effective than many hormonal birth control methods or an IUD, but effectiveness improves when combined with condoms and other methods.
Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.
Do you regularly experience urinary tract infections (UTIs)?
Using Phexxi and sexual activity may increase your risk of urinary tract infections (UTIs). It is recommended to urinate immediately after intercourse to help reduce this risk. If you notice that you develop UTIs more frequently while using Phexxi, it is recommended to stop the medication.
Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.
Have you experienced an allergy reaction to Phexxi in the past or do you have any known allergies to some of its ingredients such as lactic acid, citric acid, or potassium bitartrate?
Have you ever had severe irritation or burning from other vaginal gels, creams, spermicides, or lubricants?
Phexxi may cause vaginal burning, irritation, or discomfort in some users. If you have experienced severe irritation with other vaginal products in the past, you may be more likely to notice these side effects with Phexxi. If the irritation becomes bothersome or persistent, it is recommended to stop using Phexxi and contact your healthcare provider.
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