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Contraceptive Pill Review

Please only complete the following questionnaire if requested by your GP practice as part of your routine oral contraception review. This questionnaire is for a routine review of your use of contraception.
6. Have you been experiencing side effect since you started taking the pill?(Required)
8. Do you currently experience or have a history of Migraines?(Required)
9. Have you ever had any blood clots? (e.g. Deep Vein Thrombosis or Pulmonary Embolism)(Required)
10. Have you ever had a heart attack or stroke?(Required)
11. Have you ever had breast cancer or cervical cancer?(Required)
12. Have you considered other types of contraception?(Required)
13. Do you have a family history of any of the following? Please select any that apply
14. I have read the links to the leaflets below and understand the benefits and risks of oral contraception?(Required)
15. Would you like any further information about Long Acting Reversible Contraception (e.g. contraceptive implant or coil)?(Required)
16. If you would like to receive further information about alternative contraception, please select the options you are interested in below:

Please be aware that some medication can reduce the effectiveness of ‘the pill’ (combined oral contraceptive pill) so if taking new medication, always check with the pharmacist or prescriber (this includes St John’s wort which you should avoid). Please take a look at the links below for further advice

General advice on the pill

General advice on contraception

What to do if you miss a pill

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