Contraceptive Pill Questionnaire

In order to provide the contraceptive pill safely we need to ask you a number of questions.

We would be grateful if you could download and complete this form and get your blood pressure, height and weight checked at the surgery on the machine in the waiting room. Once complete, please hand the form to the receptionist.

Like all prescription requests, it will take at least 2 working days for contraceptive pill requests to be processed.