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eFill Request

  • You must have a current contraceptive order for this medication on file with UWEC Student Health Service.
  • You must have obtained contraceptive supplies from us in the past to use the eFill ordering system.
  • If you have any questions about your medications or are having problems with your method of birth control-please call the SHS at 836-4311 and request to speak with a nurse.

Please read the following statements and check the appropriate response:

I am not having any of the following symptoms:

  • A abdominal pain-severe
  • C chest pain-severe
  • H headaches (severe) dizziness, weakness, numbness
  • E eye problems (vision loss or blurring) speech problems
  • S swelling or pain in one leg

I am not having any unusual symptoms or problems with my birth control method.
I am not off schedule with my method.

Important Family Planning Waiver Changes effective August 2006
All new applications and reapplications for FPW will require proof of identity for all applicants and proof of citizenship if you were not born in WI. Please bring a photo ID (Blugold card/Driver's License) and if you were not born in WI, please bring a passport or certified copy of your birth certificate. Please call 836-4311 if you have questions.

eFill Request website