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Ella Pill Eligibility Check

Answer a few quick questions to see if this medication is right for you

Ella Pharmacy Pickup Form

When was the first day of your last period?

Are you currently breastfeeding?

Yes

Are you over 195 lbs.?

Yes

While there is some concern that emergency contraceptives are not as effective with females who are over 195 pounds.

Have you used emergency contraception in the past 30 days?

Yes

Please know that this medicine cannot be used within the same menstrual cycle. Also, it may diminish the therapeutic effect of Plan B and vice versa, so you should not take these two medicines within the same menstrual cycle either.

Are you taking any of the following medication: barbiturates (phenobarbital and other meds that end with -barbital), bosentan, carbamazepine, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John’s Wort, or topiramate?

Yes

How often do you have intercourse monthly?

Less than 12 times a month

12-24 times a month

More than 24 times a month

Information about yourself

Gender assigned at birth

Male

Female

Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.

Are you pregnant?

Yes

Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.

Are you at least 18 years old?

Yes

Unfortunately, we are unable to provide this service for you. Please see your provider in person for care.

First Name

Last Name

Please enter the information of your pharmacy below.

Pharmacy Name

Pharmacy Address

Address Line 1

City

State

Zip Code

By proceeding, you acknowledge that the information provided is confidential and will be used solely to conduct an initial eligibility check. This first step helps determine if the medication may be suitable for you.

Please note that this does not guarantee a prescription. A licensed physician will perform a full review of your information to ensure this is a safe and appropriate treatment for your specific health needs.

Online Prescriptions For Travel Sickness Medicine

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Ella (30 mg)$45.00

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$75.00

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