WV Family Planning Program
Provider Information/Training
Patient Data Form Instructions
 

FP Clinic Number:  
FP Clinic Number:  
              

IMPORTANT: Every time you access the Patient Data Form and instructions, you must click on the blue logout box at the top of the form when you are finished. If you forget to logout, no one at your clinic will be able to login to the web course for at least 20 minutes.

Questions about course content should be directed to Family Planning Program staff at 1-800-642-8522 or (304) 558-5388.