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.

Please be aware that any replies from the surgery may appear in your junk or spam inbox.

Medication Review

Medication Review

Please check that the surgery has advised you to submit this form before doing so.

Section

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Do you understand why you have been prescribed your medication and what it is for? *
Do you know when and how to take your medication? *

Please speak to a Pharmacist or a GP to discuss the above.

Are there any concerns or side effects from the medication? *
Do you have any difficulties that affect how you take your medication? E.g. Problems swallowing, removing from containers, using inhalers or eye drops etc. *
Is there any medication on your repeat list that you are no longer taking and can be removed? *
Are you happy for the doctor to update your review date now? *
Please select one of the following: *

Please list all of the medications that require a review:

*