Contraceptive medication review
What is your name?
What is your date of birth?
For example, 31 3 1980
What is your sex?
As recorded on your medical record
The one used to register with your GP
Anyone else with access to your email account may see responses sent to you

About You

In Metres
In KG
Do you currently smoke?
Any family history of breast cancer?
Any personal or family history of blood clots or strokes?
Any history of liver disease?

Contraception Pill Review

Do you regularly check your breasts?
Do you suffer from severe headaches or migraines?
Are you experiencing any irregular bleeding?