Progestogen Contraception Review

If you have been advised by the surgery to do so, please submit this form.

Progesterone Contraception Review

About You

In Metres
In KG
Smoking status: *
Would you like to give up smoking?
Are you up to date with your cervical screening (smear)? *
Are you up able to provide a blood pressure reading? *

Are you remembering to take your contraception daily? *
Is there any change in your vaginal bleeding pattern, or concerns about this? *
Any recent change in other medications, your own general health or family illnesses? *
Are you happy to continue your current contraception method? *

The doctor may be able to update your review for the next 6 months.

For your next check a nurse appointment will be required.

*