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 have been advised by the surgery that your medication review is due please use this form.

Medication Review

If you are human, leave this field blank.

Full Name: *

Phone Number:

Named GP (if known):

Do you have any concerns or side effects from your medication? *

Yes

Please specify:

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

Yes

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

Are you happy for the doctor to update your review date now? *

Yes

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

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Medication Review

Flu