MiniPill Review

"*" indicates required fields

Please read and complete this form to continue your prescription for the Minipill.

The Minipill is also known as the progesterone only pill (POP) and types include Desogesterol, Cerelle, Cerazette and Noriday

Information regarding the benefits and risks of this pill can be found here

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

Please confirm that you have read and considered the above information about the Minipill.*

Do you have a history of breast cancer, blood clots, stroke or heart attacks?*

Have you considered a more reliable form of contraception such as the Coil, Implant or Injection? (see below)*

COIL Information
IMPLANT Information
INJECTION Information

Are you happy with your Minipill?*

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.

Please read our privacy policy to understand how we protect and manage your submitted data.