Bladder Medication Review

"*" indicates required fields

Bladder medications include Solifenacin, Oxybutynin, Tolterodine, Duloxetine and Mirabegron.

After submission of this form:

- The practice will continue your medication as usual if you have indicated you are happy with things

- Otherwise the practice will contact you in a few days time days time to arrange a review.

Name*
DD slash MM slash YYYY
eg Dr Turnbull / Dr Brooks

You have been asked to complete this form to let us know whether you think your medication is working.

These medications usually improve bladder symptoms but sometimes there is little improvement and we would like to know whether you would like to continue, stop of change the medication.

More information on helping your bladder symptoms can be found here.

How would you like to proceed with your medication?*

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our privacy policy to discover how we protect and manage your submitted data.
Consent*

© 2022 Kristian Turnbull

This field is for validation purposes and should be left unchanged.