As part of our continued commitment to our dispensing patients we annually review the use of repeat medication.
Use this if you are a dispensing patient and come under any of the following categories:
- Patients who are taking four or more medications
- Patients who are diabetic
- Patients taking anti-coagulants (blood thinning medication)
- Patients who have non oral medication eg. eye drops, ointments, injections etc
We would be grateful if you could answer this questionnaire on your medication and be as honest as possible so any problems can be identified and addressed if required.
This form is for patients who have their medication dispensed by the surgery and not the pharmacy.
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
You can also phone us on 01777 870203.