Safer Sex Referral Form & Resource Binders
The “Safer Sex for Every Body” referral form is a resource for community providers to use with their patients and clients when discussing sexual health and making referrals to care.
The front side is a visual aid to help providers initiate and guide discussions about safer sex, STI prevention, and birth control options.
The back page includes a referral form to help providers support their patients to select a sexual health care provider of their choice and schedule an appointment.
The “Safer Sex for Every Body” referral form is available in 11 languages. It’s designed to print on one piece of paper as a double-sided resource.
Click a language below to download:
The Safer Sex for Every Body Referral Form is accompanied by a short “How to Use” guide with a script for providers. Download the guide here.
Sexual and Reproductive Health Resource Binders for Community Providers
We offer community providers a packet of free supplemental resources to accompany the “Safer Sex for Every Body” referral form. The packet includes materials selected from trusted sources, such as CDC and Planned Parenthood Federation of America, and provides information to share with patients about healthy relationships and consent, gender identity and sexual orientation, safer sex, sexually transmitted infections (STIs), reproductive life planning and birth control, and making referrals for care in Maine, New Hampshire, and Vermont.
Upon request, the supplemental resource packets are available as PDFs that can be downloaded to your device or printed and put into a binder for use in the office. The supplemental packets are available with state-specific content for Maine, New Hampshire, or Vermont in the following formats:
- Sexual health resource packet for adult-serving professionals in Maine, New Hampshire, or Vermont. Examples of adult-serving professionals include clinicians, social workers, and case managers.
- Sexual health resource packet for youth-serving professionals in Maine, New Hampshire, or Vermont. Examples of youth-serving professionals include pediatricians, teachers, health educators, and school nurses.
Our Population Health and Education team is happy to adapt these resources to meet the unique needs of your patients or clients in Maine, New Hampshire, or Vermont. We also offer free, online professional development training on how to use the referral form and supplemental resource packets in binder form. Please contact us to request a supplemental resource packet or to schedule a training: [email protected].