Contraceptive Pill Review

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

Contraceptive Pill Review - Baldock

About You

Please use this date format: DD/MM/YYYY.
Please let us know your preferred contact number in case we need to contact you.

Blood pressure

Visit the British Heart Foundation Youtube Video for information about how to take your blood pressure reading at home.

Contraception Pill Review

Current smoking status:
Do you regularly check your breasts?

Please ask reception for our information regarding the importance of regular breast self-examination.

Do you suffer from severe headaches or migraines?

Please make an appointment to see your doctor to discuss your headaches if you have not already done so.

Are you experiencing any irregular bleeding?

Please book an appointment to see the practice nurse

Do you take any non-prescribed medication?
Have any members of your family had a blood clot on the legs or lungs, cancer, heart attack or stroke?
Are you happy with the pill that you are taking and wish to continue?

Please note that long-acting reversible contraceptives or LARCs (IUD/IUS/injections/implants) are the most reliable and safest contraception options.

If you would like more information about LARCs, please visit www.fpa.org.uk/sites/default/files/long-acting-reversible-contraception-your-guide.pdf and make a routine telephone appointment with a GP.

Terms & Conditions

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