Medication
Review Form

HRT (Hormone Replacement Therapy)

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HRT (Hormone Replacement Therapy)
Review Form

Required fields are marked with an asterisk (*).

We have reviewed our prescribing and monitoring of hormone replacement therapy. (HRT).

All patients who are on HRT need to have a review 3 months after starting medication and every 12 months thereafter.

Your annual review can be done by completing this questionnaire as long as the original prescription was issued by Teldoc Medical Practice and you are happy with it and wish to continue with your current therapy.

If you have been advised by the practice to submit an HRT Review Form please use this form.

Your prescription will be processed and be available for collection within the usual processing time of 5 working days. You will only be contacted by the practice if there are any follow up questions from the GP/PN.

Your Details

Personal History
Family Medical History
Blood Clot Awareness
Hysterectomy
Side Effects
Advice / Knowledge
Health Screening
Privacy Consent – This form collects personal and medical information about you/ We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage submitted data.

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Update - Please note the practice will be closed from 6pm on Friday 23rd May until 8am on Tuesday 27th May due to the Bank Holiday.

Think which service? - NHS Shropshire, Telford and Wrekin (shropshiretelfordandwrekin.nhs.uk) Please dial 111 for any non-urgent medical issue that cannot wait until the practice reopens. As always please only dial 999 for any urgent/life threatening matters.

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