Contraceptive Pill Check

Patients who are over 16 and already taking the contraceptive pill which has been provided by ourselves may no longer be required to attend for a pill check appointment.
We now use a questionnaire for patients to order their contraceptive pill repeat prescriptions

You can download the form below and either return the completed form via email to or drop it off at reception. Please ensure your contact details are completed as we will need to contact you if there are any queries with your request.

We require a up to date BP and Weight in order to issue the this prescription. Please note you can check your BP and Weight free of charge on the machine at Cottam Lane Surgery, Please attach the printed slip from the machine to your form.

If you have any questions regarding the questionnaire please contact the prescription line.

PDF PILL CHECK QUESTIONNAIRE Contraceptive Pill Checklist 06.19

WORD PILL CHECK QUESTIONNAIRE Contraceptive Pill Checklist 06.19

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