Contraception Review

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

Contraception Review

Contraception Review

About You

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Contraception Review

Are you registered with the practice?
Is this the first time you are looking for this service?
Which form of contraception do you require?
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