Online Contraceptive Pill Review

All of this form needs to be completed before you prescription will be issued and you may still require a face to face/telephone appointment if it is felt necessary. Please complete this form at least 2 weeks before your prescription is due.

Online Pill Review
All sections must be completed as a minimum standard. A blood pressure reading must be provided.
If the answer to any of these questions is yes, then please book an appointment with a Family Planning Trained Nurse.