Contraceptive Review

Contraceptive Pill/Patch/Ring Review

Contraceptive Pill/Patch/Ring Review

About You

Please use this date format: DD/MM/YYYY.
Responses we send will go to this email address
In cm (168)
In KG (57)

Contraception Review

Does it suit you well?
Do you smoke?

If you are interested in help or advice on quitting, please visit: https://www.nhs.uk/smokefree

Have you ever smoked?
Do you regularly check your breasts?

Please ask reception for our information regarding the importance of regular breast self-examination.

Do you suffer from severe headaches or migraines?
Do you get visual changes before hand telling you they will start soon?

Please make an appointment to see your doctor to discuss your headaches if you have not already done so.

Have you or anyone in your close family had a deep vein thrombosis or clot on the lung (PE)?
Do you take St John's wort (a herbal remedy for low mood)?
Are you experiencing any irregular bleeding?

Please book an appointment to see the practice nurse

Do you want information about other contraception options?
Would you like advice about sexual health screening?
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