Have you already taken any emergency contraception for this incident?

Are you currently using any regular form of contraception?

 e.g. pill, implant, IUD, condoms

Are you currently pregnant or do you think you could be pregnant?

Have you had unprotected sex more than once in this menstrual cycle?

Are you currently breastfeeding?

Do you have any known allergies?

(especially to ulipristal acetate, levonorgestrel, or lactose)

Are you taking any medicines or herbal remedies?

e.g. epilepsy medicines, St John’s Wort, HIV treatment, rifampicin, omeprazole, etc.

Do you have any liver disease or serious medical condition?

When was the first day of your last period?

Was your last period normal for you?

Have you had unprotected sex since your last period before this incident?

Do you understand that emergency contraception should be taken as soon as possible for best effectiveness?