Contraceptive management / Birth Control Rod

HISTORY: 
[textarea default="Patient requests contraception. She is not currently taking any birth control."]
LMP: [date]
Tobacco Use: [select value="no|yes"]
Hx of migraines with aura: [select value="no|yes"]
hx of STI: [select value="no|yes"]
Hx of DVT/PE: [select value="no|yes"]

EXAM: 
[textarea default="Vital Signs Within Normal Limits.
GENERAL: Well Developed and Well Nourished Female, Alert and oriented x 3, in no distress."]
ASSESSMENT/PLAN:
[textarea default=" discussed contraceptive means available including IUD, nuvaring, combination oral contraceptives tabs/ patches and progesterone only contraceptive injections vs tabs
She wishes to proceed with ***.
Urine HCG obtained and is ***NEGATIVE***
Benefits and risks discussed with patient."]