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.

Medication Review

Section

Review

Do you understand the reason why you are taking each of your medications? *
Do you understand how to take each of your medications? *
Are there any barriers you have with taking your medication? *
Are you currently taking each of your medications as they are prescribed on the label? *
Do you get any side effects from the medication you are taking? *
Do you take any other medications (including supplements or herbal remedies) that have not been prescribed? *
Are there any of your prescribed medications you feel you no longer need or have already stopped? *
Smoking Status: *
Please provide a weight and/or height reading: *
Do you have any other concerns relating to any of your medications? *
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