Contraceptive Pill Review
In order to provide the contraceptive pill safely, we need to ask you a number of questions. We would be grateful if you could complete this form when you submit your next repeat prescription request. Failure to complete this review on an annual basis could significantly delay your prescription.
If you are having any problems with your medication or would like to consider alternative contraception options, please speak to one of our Practice nurses, who will be able to advise you, or refer you to a GP as appropriate.
Thank you for completing this form, please return by email to firstname.lastname@example.org or hand into reception, please remember we require a blood pressure reading every 12 months.
If there are any problems with re-issuing your prescription we will contact you.