If you can’t complete the form online, appointments are available by calling the clinic on 0300 373 0709. You may need a telephone assessment before being offered an appointment for your procedure.
Ideally, children should not come to your appointment but we understand that sometimes this is unavoidable. If your child does come with you, please make sure they are in a pushchair or buggy that they can be securely strapped into, or they are accompanied by an adult who will be able to care for them during the appointment.
Coil (IUCD) procedures
If you need or have been advised to have a copper coil fitted for emergency contraception following an episode of unprotected sex, please contact us as soon as possible on 0300 373 0709.
This form is not for women wanting an IUCD for the treatment of gynaecological problems, e.g. to reduce heavy menstrual bleeding or for perimenopausal symptoms as part of your hormone replacement therapy. Please contact your GP to have your procedure or to be referred to Gynaecology.
As of this year, licensing for the Mirena, Benilexa and Levosert coils has been updated. If any of these devices were inserted before the age of 45, they are now known to be effective for contraception for eight years. This means these coils only need to be replaced if they were inserted eight years ago or more, if used for contraception. If used for HRT purposes, the guidance remains the same and they should be replaced after five years.
An IUD (copper coil) fitted at or after the age of 40 does not need replacing and will be effective for contraception until 1-2 years after your last ever period. This is usually around the age of 50-51 years.
An IUS (Mirena/Levosert/Benilexa) fitted at or after the age of 45 will be effective for contraception without the need for an exchange until the age of 55. At 55, it can safely be removed without further risk of pregnancy.
Kyleena and Jaydess hormonal coils still need to be replaced at five and three years from insertion, respectively.
If you require any type of coil removed, or inserted or exchanged for contraception, please complete the relevant form below and follow the instructions:
Once you have returned the form, we will be in touch within 14 days to book your appointment. Please contact us at mtw-tr.coilassessmentdoc@nhs.net if you don’t hear from us within 14 days of submitting your form.
Implant procedures
Please book implant removals directly by calling 0300 373 0709. For implant insertions or exchanges, please complete the relevant form below and follow the instructions:
Once you have returned the form, we will be in touch within 14 days to book your appointment. Please contact mtw-tr.coilassessmentdoc@nhs.net if you don’t hear anything within 14 days of submitting your form.