Copy of - Contraceptive Pill Review Form

If you have been advised by the surgery to submit a contraceptive pill review please use this form.

This form is for the repeat prescription of the combined oral contraceptive pill (COC) and the progesterone only pill (POP) and available if you are a current user of this method and have already been prescribed this method in the last 12 months. 

If you take any oral contraceptive pills you will need an annual review ("pill check") at least every 12 months before we can reauthorise your prescription. You may be due a review sooner if you have recently started or changed your pill.

This form will allow you to complete the pill check online. We have set this up with the aim of making it quicker and easier for you to renew your prescription if your pill is suiting you and you wish to continue it. If you are having any problems or concerns or to discuss other forms of contraception, we would be more than happy to hear from you. Please make an appointment with a GP or the practice nurses. 

The pill check form will be sent to the practice team and your request will usually be processed within 5 working days. If there are any issues we will contact you to discuss further. If there are no issues we will not contact you and you may collect your prescription from the practice or your nominated pharmacy.

If you need help navigating the form, please call the practice. 

Last Updated: 24/05/2024

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