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birthcontrolph

Free printable

Reseta request script

Editorially reviewed on October 29, 2026. [TODO: medical reviewer]

Quick answer

What to say at a teleconsult or clinic to ask for a birth control prescription or refill. For: anyone needing a prescription. Download the A4 PDF or read the full text below.

Download A4 PDFAll printables

Full text

English

Hi doc, I would like a prescription for birth control pills. I have been taking [brand] since [month/year] with no problems. My blood pressure was [reading] on [date]. I do not smoke. Could you write a prescription for [3/6/12] packs, with the generic name, so I can buy it at any pharmacy?

Taglish

Hi doc, gusto ko po sanang humingi ng reseta para sa pills. [Brand] po ang iniinom ko mula [buwan/taon], wala naman pong problema. Hindi po ako naninigarilyo. Pwede po bang isulat para sa [3/6/12] pack, kasama ang generic name, para makabili ako sa kahit anong botika?

If it is your first time

  • Say why you want contraception and what matters to you (cost, acne, breastfeeding, forgetting pills).
  • Mention any migraine with aura, clots, high blood pressure or smoking.
  • Ask about cheaper same-formula brands.

Free to print and share at health centers, schools and clinics. Please keep the website line at the bottom.

This guide is for information. Talk to a doctor before starting, stopping or switching birth control.

Sources

  1. Explainer: Philippine Pharmacy Act and prescription medicines, Interaksyon (Philstar), 25 Apr 2024
20s and 30s: birth controlbirthcontrolphilippines.comPCOS at any agepcosphilippines.com40s and beyond: perimenopause and menopausemenopausephilippines.com