Contraceptive Pill Review

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

Contraceptive Pill Review

Contraceptive Pill Review

Do you consent for text messaging from the surgery? *
In Metres

Contraception Pill Review

Are you a smoker? *

You can access help with stopping smoking from

Are you able to provide a blood pressure reading? *

If you are taking a combined pill, your blood pressure must be checked at least annually to check that it is suiting you.

Please use date format: DD/MM/YYYY
Do you suffer with Migraines? *

If you are taking a combined pill and you have developed migraines/headaches you must arrange an appointment to check your symptoms as soon as possible.

Do you have any concerns regarding your pill? *

Please contact the surgery for a pill check.

Are you aware what to do if you miss a pill and how to access emergency contraception if needed? *

If you miss a pill, please take the last pill that you forgot straight away and read missed pill advice in your leaflet. 

If you are not sure what to do, please contact the surgery, 111 or family planning clinic via

Has there been a change in your health or new health conditions since your last pill check? *
Are you happy to continue taking your pill? *

If you would like to consider alternative methods including coils/implants, please continue taking your pill and contact the surgery to arrange an appointment.

Progesterone Only Pill (POP)


Common POPs include:

  • Desogestrel
  • Cerelle
  • Cerazette
  • Feanolla
  • Desmono
  • Desorex
  • Moonia
  • Zelleta
  • Noriday

Combined Pill (COCP)


Common Combined pills include:

  • Microgynon
  • Ovranette
  • Levest
  • Rigevidon
  • Gedarel
  • Mercilon
  • Femodette
  • Millinette
  • Marvelon
  • Yasmin
  • Yacella
  • Femodene
  • Norimin
  • Brevinor
  • Cilique
  • Logynon

Please note this list is not exhaustive.

Would you like your review to be completed without an appointment? *

For Further Advice

You can contact any of the following services: