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.

Please fill in this form to help us complete your medication review and update your medication.

Medication Review

Medication Review


Do you know what your medications are for? *
Do you know when and how to take your medication? *
Are you taking your medications as they are prescribed? *

Please book a routine review with your GP to discuss the issues you have raised above.

Are there any concerns or side effects from the medication? *
Have you stopped any medications on your repeat list? *
Are you happy for the doctor to update your review date now? *

About you

If you are able to, please provide the following:

Smoking status:

For advice about quitting smoking, please visit Smokefree Norfolk or call 0800 085 4113.

Blood Pressure (if you take your own readings)