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Weight Assessment

Please ensure you enter accurate height and weight details as this may affect future prescribing decisions

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Your BMI:

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About You

About Your Health

  • You are or maybe pregnant
  • You are planning to fall pregnant
  • You are breastfeeding
  • You have menstrual bleeding patterns have changed recently
  • Any cardiovascular problem (ie. Heart attack
  • unstable angina or stroke)
  • Crohn’s disease
  • Ulcerative colitis
  • Diabetes
  • High cholesterol
  • Migraines
  • Any kidney problems
  • Any liver problems
  • Systemic lupus erythematosus
  • Cancers
  • Stroke
  • Thrombosis
  • Heart attack

About Your Medications

About Your Agreement

  • You have capacity to understand all about the condition and the treatments available here.
  • The treatment for your own use only.
  • You have read and understood what the treatment options / benefits and risks / side effects associated with them.
  • You will read the patient information leaflet before taking the treatment and use the treatment as directed.
  • You will contact your doctor if you experience any adverse effects or symptoms change following the start of treatment.
  • You have answered the above questions accurately and honestly.
  • You acknowledge that if you are aged over 25 years you are advised to have a smear test every 3 years.
  • You acknowledge that contraception is not 100% effective.
  • You acknowledge that if you are having unprotected sex you are at increased risk of sexual transmitted diseases and your should get tested regularly.

GP Consent