Contraceptive Pill Review

If you have been advised by the surgery to submit a contraceptive pill review please use this form.

Please only submit this form if you have been specifically asked to do so by a clinician at the practice.

Contraceptive Pill Review

Contraceptive Pill Review

In Metres
In KG

Contraception Pill Review

Do you regularly check your breasts?

Please ask reception for our information regarding the importance of regular breast self-examination.

Do you suffer from severe headaches or migraines?

Please make an appointment to see your doctor to discuss your headaches if you have not already done so.

Are you experiencing any irregular bleeding?

Please book an appointment to see the practice nurse

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