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.

Section

Height *

In Metres

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

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Hucclecote Surgery is at the heart of the community and our main aim is to provide correct and beneficial healthcare to the patients of Hucclecote Surgery. As some of you may be... Find out more

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We can help you without needing a GP appointment, with the following 7 symptoms below: Sinusitis - (adults and children aged 12 years and over) Sore Throat - (adults and ch... Find out more

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Dear Patients, Hucclecote Surgery records all telephone calls for training and monitoring purposes. Thank you.

Important -

Due to the increase in prescription requests, Hucclecote Surgery now require 72 working hours to process all prescription requests. Patients can order all requests 2 weeks prior to... Find out more

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