Contraceptive Pill Review

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

All messages will receive an email response (to the input address) – please check your email address given and junk/spam folder if you do not receive a response.

Contraceptive Pill Review

Contraceptive Pill Review

About You

In Metres
In KG
Smoking status:

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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