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Birth Control Tracking Kit
A plain birth control tracking kit for pill packs, patch, ring, shot, missed doses, illness, medicine interactions, travel, switching, and privacy-light notes.
Birth control questions are easier with facts, not guesses.
This kit is a set of short worksheets. Pick the ones that match your method and your question.
It is not medical advice.
It does not give dosing rules, missed dose steps, backup advice, or pregnancy interpretation.
Use your package instructions. Ask a pharmacist or clinician for anything about your exact medicine or method.
Method ID card
Fill this in once. Keep it with your medicine notes.
Question Your note Method pill / patch / ring / shot / implant / IUD / other Name or brand Pill type, if known combination / progestin only / not sure Start date Pharmacy Prescriber or clinic Package paper found? yes / no / not sure Main question
If you are not sure, write "not sure." Do not guess.
Pill pack notes
Use one row per week if you use pills.
Week Dates Bleeding Symptoms Missed or late note Question Week 1 none / spotting / bleeding Week 2 none / spotting / bleeding Week 3 none / spotting / bleeding Week 4, if used none / spotting / bleeding
MedlinePlus says missed pill next steps for combination birth control pills depend on pill type, where you are in the cycle, and how many pills were missed. Ask a pharmacist or clinician what applies to your exact pack.
Patch notes
Use this if you use the patch.
Date Patch site skin note Bleeding Symptom Question redness, itch, pain, rash, none none, spotting, bleeding
CDC's combined hormonal contraceptive guidance covers combined transdermal patches and notes that irregular bleeding patterns are common among healthy people. It does not tell you when to change a patch or what to do if a patch is late or loose. Ask a clinician or pharmacist, or check the patient label for your patch.
Ring notes
Use this if you use a vaginal ring, such as NuvaRing.
Date Bleeding Flow Pain 0 to 10 Ring context note Other symptoms : none, spotting, bleeding light, medium, heavy short factual note cramps, nausea, discharge, headache
MedlinePlus lists vaginal rings as a hormone based birth control method. This log does not tell you what to do with your ring. Ask a clinician or pharmacist about ring timing, missed use, late use, or method changes.
Depo shot bleeding calendar
Use this if you use the Depo shot.
Item Your note Shot date Shot type, if known Next shot date given Current medicines or supplements
CDC guidance says amenorrhea, spotting, and light bleeding are common with DMPA use, and heavy or prolonged bleeding can also occur. Use one row per week for a 3 month bleeding count.
Week No bleeding days Spotting days Bleeding days Heavy days Cramps days Headache days : : : : : : 1 2 3 4
This calendar does not give treatment steps. It helps you bring clear dates and symptoms to a clinician.
Missed pill question list
Use your pill package first. Call a pharmacist or clinician if the instructions are unclear, you do not know your pill type, you missed more than one pill, you were sick near a dose, or you had sex and feel worried. Seek urgent care if you feel very sick.
Question Your note Pack week first / middle / last / not sure Number of pills missed Missed pill date and time Vomiting or diarrhea near a dose yes / no / not sure
CDC's combined hormonal contraceptive appendix says missed pill actions depend on factors such as how many pills were missed and where you are in the cycle. This list does not answer that for you. It helps you ask.
Illness, vomiting, and diarrhea notes
Illness can make a dose question feel urgent. CDC's 2024 U.S. Selected Practice Recommendations include clinician guidance for vomiting or diarrhea while using combined oral contraceptives.
Date Pill note Vomiting Diarrhea Other medicine Question taken / late / missed / not sure none / yes / not sure none / yes / not sure
This sheet does not tell you what dose to take. It does not tell you if you need another method or emergency contraception.
Antibiotics and other medicine questions
CDC's 2024 U.S. Selected Practice Recommendations give clinicians guidance for common contraceptive use questions, including drug interactions. The combined hormonal contraceptives guidance includes a drug interaction appendix.
Item Your note Antibiotic or new medicine name Dose as written Start date Birth control name Pharmacy question
This page does not give interaction rules. Ask a pharmacist to review your exact antibiotic or medicine with your exact birth control.
Supplement and St. John's wort disclosure
FDA says dietary supplements can include vitamins, minerals, herbs, amino acids, and other ingredients, and recommends telling health care professionals about supplements. NCCIH lists St. John's wort specifically as a supplement to discuss with a clinician or pharmacist when you take medicines.
Supplement name Form Label amount How often used Question pill / gummy / tea / powder / drop / other
Bring the bottle, package, or a label photo. FDA says it does not approve dietary supplements before they are marketed, so labels matter more than nicknames.
Full medicine interaction checklist
Use this before any pharmacist or clinician review.
Birth control package, box, ring pouch, patch box, shot record, implant card, or IUD card. Prescription bottles. Over the counter medicine packages. Vitamins, herbs, and supplements. Recent antibiotics or short term medicines. Medicine you stopped or missed by mistake. Allergy list. Main question for a pharmacist or clinician.
MedlinePlus suggests bringing a list of medicines, vitamins, supplements, symptoms, and questions to health visits.
Side effect tracker
Use a 0 to 3 score. 0 = none. 1 = mild. 2 = changed my day. 3 = hard to manage.
Date Bleeding Mood Headache Nausea Acne Libido Breast tenderness Cramps : : : : : : : none, spotting, bleeding
ACOG lists possible side effects for combined hormonal birth control, including headache, nausea, breast tenderness, and breakthrough bleeding. A tracker can show timing. It cannot prove cause. If you feel unsafe or may hurt yourself, seek urgent help now; the 988 Suicide & Crisis Lifeline is available for anyone in crisis.
Travel and time zone questions
Travel can make a pill reminder feel confusing, especially across time zones. This kit does not do time zone math or set dosing times.
Trip detail Your note Home time zone Travel time zone or zones Travel dates Package instructions location
Ask a pharmacist or clinician how your package directions apply to your trip.
Refill and pharmacy privacy
A refill can create texts, emails, app alerts, receipts, delivery labels, insurance records, and shared account clues. HHS says people have HIPAA rights around health records, but HIPAA has limits and exceptions, and many consumer apps fall outside HIPAA's covered entities. The FTC tells mobile health app developers to minimize data and limit access and permissions.
Item Your note Pharmacy Alert types on text / email / app / call / mail Family access on / off / not sure Refills shown Next refill date shown
Low detail reminder labels:
Detailed label Lower detail label Birth control pill Check pack Take pill now Daily note Birth control refill Refill note Call pharmacy about birth control Call pharmacy Prescription problem Health task
Switching methods
Use this before a visit if you are considering a switch.
Question Your note Current method Start date What you like about it What you want to change Bleeding pattern Side effects to discuss
CDC U.S. Medical Eligibility Criteria give clinicians recommendations for contraceptive method safety based on health conditions or characteristics, such as migraine with aura, high blood pressure, blood clot history, smoking and age over 35, or medicine interactions. A clinician or pharmacist can help match options to your health history and goals. This checklist does not choose a method for you.
One page visit summary
Fill this out before any call, message, or visit.
Summary item Your note Method and name Main question Bleeding pattern Main symptom New medicines or supplements Missed or late dose notes, if any What worries me most What I need help with
Privacy light notes
Birth control notes can show sex, pregnancy worry, clinic names, pharmacy names, infection names, and medicine use.
Keep only what helps care.
Instead of Try Full pharmacy screenshot "Pharmacy label question." Full medicine list in a calendar alert "Medicine list review." Long sex or pregnancy note in a shared app "Private question for clinician." Full birth control label in a shared album "Birth control label saved privately."
The FTC has alleged that at least one period tracking app shared sensitive health data with outside analytics providers after making privacy promises, which is useful context for keeping notes low detail by default.
Floriva note
Floriva can keep short cycle and symptom notes on your device.
It does not review medicines, interpret bleeding, promise privacy, or replace your package instructions, pharmacist, or clinician.
For visit prep, read Floriva for gynecologist prep. For emergency contraception questions, use the emergency contraception and Plan B log.