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.

Are you completing this form on behalf of

About You

Full Name
Date of Birth
Do you have any concerns or side effects from your medication?
Do you know when and how to take your medication?
Are you happy for the doctor to update your review date now?