Contraceptive Pill Review

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

If you are human, leave this field blank.

About You

Height *

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Weight *

In KG

Contraception Pill Review

Do you regularly check your breasts?

Yes

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

Do you suffer from severe headaches or migraines?

Yes - But the Doctor is unaware

Yes - But the Doctor is aware

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?

Yes

Please book an appointment to see the practice nurse

I confirm that the information provided is accurate to the best of my knowledge

Important -

We would like to inform patients that we will shortly start the process of selling the surgery, as it will be surplus to our needs when we move to our new premises. This will mean ... Find out more

Important -

Our GPs, Nurses and practice staff are working very hard to support the accelerated booster programme, in line with the national emergency Omicron policy. This means that for the n... Find out more

Important -

The NHS in Gloucestershire is reassuring everyone over 18 who is eligible for a COVID-19 booster that they will receive an invitation from local NHS services to book in for their v... Find out more

Important -

England’s Chief Nurse has today reminded the public that everyone accessing or visiting healthcare settings must continue to wear a face covering and follow social distancing rul... Find out more

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