Medication Review

We review any regular medication on a repeat prescription annually and wherever possible the doctor will do this without you having to attend the surgery.

If you are a dispensing patient with three or more items on repeat and have been advised by the practice to do so, please complete this form.

Medication Review

Medication Review

It is important for you to complete the required information for your review. We need this to ensure your medications remain effective and also to discuss any changes which may be beneficial to your health. Without this information we may not be able to continue issuing your medications in the usual way.

Section

Medication Questions

Are there any concerns or side effects from the medication? *
Are your medicines effective in controlling your symptoms? *

Please speak to a Pharmacist or a GP to discuss your symptoms.

Do you know when and how to take your medication? *

Please speak to a Pharmacist or a GP to discuss when and how you should take your medication.

Do you understand the purpose of each of your medications? *

Please speak to a Pharmacist or a GP to discuss the purpose of your medication.

Have you stopped taking any medication? *
Are you happy for the doctor to update your review date now? *

Readings

Please provide a blood pressure reading.

/

Smoking

Smoking Status: *
Are you interested in advice on how to quit?

Additional Questions

Do you buy Aspirin and take daily?
*