Form to Request Trainings for the PA PQC Immediate Postpartum LARC Initiative

Directions:

PA PQC healthcare teams participating in the Immediate Postpartum LARC initiative in 2022 are eligible to request trainings that the PA PQC will help to organize in partnership with ACOG's Postpartum Contraceptive Access Initiative (PCAI). The PA PQC is also working with Organon to organize trainings for Nexplanon insertion. Please use this form to request a training, and the PA PQC will be in touch with you to learn more about the training that is needed, the logistics, and next steps. (PA PQC healthcare teams that participated in the IPLARC initiative in 2020 or 2021 but did not complete in-person IUD insertion/removal trainings due to COVID-19 will be prioritized for this training initially.)

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* 1. PA PQC Hospital

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* 2. Name, title, and organization of the person completing this form.

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* 3. Please select the training topic that your PA PQC healthcare team has identified as a need for providers and staff in your organization for the IPLARC initiative.

Immediate Postpartum LARC for Clinicians Doing Deliveries (including IUD insertion/removal training)

Nexplanon Implant Training (via Organon)

Billing, Coding & Payment for Immediate Postpartum LARC Services

Contraceptive Counseling for the Immediate Postpartum Period

Immediate Postpartum Contraception and Breastfeeding

The Role of Nurses in Immediate Postpartum LARC Implementation

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* 4. Would you prefer this training to be in-person or virtual?

In-person

Virtual

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* 5. Please identify an ideal, targeted timeframe for the requested training. The PA PQC will use this ideal timeframe to suggest specific dates and times.

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* 1. PA PQC Hospital

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* 2. Name, title, and organization of the person completing this form.

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* 3. Please select the training topic that your PA PQC healthcare team has identified as a need for providers and staff in your organization for the IPLARC initiative.

Question Title

* 4. Would you prefer this training to be in-person or virtual?

Question Title

* 5. Please identify an ideal, targeted timeframe for the requested training. The PA PQC will use this ideal timeframe to suggest specific dates and times.

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* 6. Please describe any previous training or work on this topic at your organization, and please describe any specific learning objectives and needs.