Downloads

Patient Intake Form

English Patient Consent Form

Spanish Patient Consent Form

A list of the hysteroscopic equipment, disposables, and supply items necessary to perform the Essure procedure. Optional equipment and supplies are also listed. This list can be ordered as a laminated card from the Literature Order page.
Equipment Supply Checklist
Equipment Supply Checklist

Text for a 30-second message that can be recorded on office voicemail systems to inform patients of the Essure procedure and its availability at the office. Worded specifically for practices in which the Essure procedure is offered in the office, hospital or ASC.

On-hold Message

Text to be printed on or included in billing statements sent to patients to increase awareness of the Essure procedure.

Billing Insert Template: English
Billing Insert Template: Spanish
Billing Insert Template: African American

Template letter for patient mailings that informs patients of the Essure procedure and its availability at your office.

Patient Letter Template: English
Patient Letter Template: Spanish

Template letter for year end patient mailings that informs patients of the Essure procedure and encourages patients to use their deductible.

Year End Mailing: English
Year End Mailing: Spanish

Complete description of the Essure procedure benefits and risks, for use during patient counseling discussions.
Patient Information Booklet: English
Patient Information Booklet: Spanish

One-page overview of the Essure procedure that can be used as a patient handout or included in a patient mailing.
Essure Procedure Consumer Overview: English
Essure Procedure Consumer Overview: Spanish

One-page flyer to promote an upcoming patient education seminar; can be included in patient mailings or posted in the office to encourage attendance.

Patient Seminar Flyer

PowerPoint presentation on sterilization options for patients or women in the community; includes detailed information on the Essure procedure.

Patient Seminar Presentation

Template letter to invite patients to attend an educational seminar on the Essure procedure.

Patient Seminar Invite Letter Template: English
Patient Seminar Invite Letter Template: Spanish

Flyer template that can be customized with your practice information; can be posted in your office or used as a mailing piece to incite interest in the Essure procedure at your practice.

Essure Practice Flyer Template
Essure Practice Flyer Template – African American

This section includes guidelines for using the HSG letters. These letters will help you: to remind Essure patients to schedule their 3-month HSG, remind Essure patients of a scheduled HSG appointment, tell patients of a missed HSG appointment and remind them to reschedule.

English Documents:
Essure Confirmation Test (HSG) Letter: Suggested Use
Essure Confirmation Test (HSG) Letter: Make Appointment
Essure Confirmation Test (HSG) Letter: Appointment Reminder
Essure Confirmation Test (HSG) Letter: Reschedule Reminder

Spanish Documents:
Essure Confirmation Test (HSG) Letter: Make Appointment
Essure Confirmation Test (HSG) Letter: Appointment Reminder
Essure Confirmation Test (HSG) Letter: Reschedule Reminder

Sample Tweets Template

Template letter that can be sent to referring healthcare professionals to give information on the Essure procedure and to inform that it is being offered and that referred patients are welcome.
Referring Physician Letter: Office
Referring Physician Letter: Hospital/ASC

A PowerPoint presentation that provides the most up-to-date results from Conceptus’ Phase II and Pivotal clinical trials. Data points include placement rates, procedure time, patient comfort and satisfaction, and safety and efficacy at 5 years. This presentation is suitable for a professional audience.
Clnical Data Turnkey Presentation

PowerPoint presentation for referring physicians and nurses; gives an overview of current permanent birth control options with detailed information on the Essure procedure.
Referring Physician Presentation

A PowerPoint presentation that provides a general overview of the Essure system and its mechanism of action. It addresses the performance, benefits and efficacy of the procedure. This presentation is suitable for a professional audience.
Essure System for Hysteroscopic Sterilization Turnkey Presentation

8.5x11 in. flyer template that can be personalized and used as an invitation for an Essure-related event for healthcare professionals.

Event Invitation Faxback Flyer Template: Invitation
Event Invitation Faxback Flyer Template: Confirmation

Physician Coding Guide

Facility Coding Guide

Instructions for linking to Essure Website

Instructions for incorporating the Essure microsite into your own practice's Website

Practice Marketing Assessment

A list of the hysteroscopic equipment, disposables, and supply items necessary to perform the Essure procedure. Optional equipment and supplies are also listed. This list can be ordered as a laminated card from the Literature Order page.
Equipment Supply Checklist
Equipment Supply Checklist

Instructions on how to perform and evaluate HSG x-rays to confirm correct micro-insert placement and tubal occlusion.
Essure Confirmation Test Protocol

Essure procedure case studies include information on medical history, pre-, during, and post-procedure actions, and follow-up. Specific cases include: Patient wanted to avoid surgery; patient wanted to avoid general anesthesia; patient was HIV positive; and patient was type 1 diabetic and had history of PID.
Case Study: No Surgery
Case Study: No GA
Case Study: Type 1 and PID

Procedure Overview
Pre-Procedure
Placement Procedure
Post-Procedure

Review of the Essure procedure steps in visual and written format; includes procedure tips and techniques.
Essure Placement Steps

A brief summary of the Essure System Instructions for Use - contains an overview of contraindications, warnings, and adverse events; written for a professional audience.
Prescribing Information Summary

A guide with tips to assist you during the placement of the Essure micro-inserts.
Troubleshooting Guide

Essure Training Manual