Annual HRT review

Annual HRT review
Are you happy with your HRT?

Your details

Please contact the surgery on 01786 822595 to make a GP appointment a face to face HRT review. We can discuss any problems you’ve encountered with your HRT and try find the right solution for you. 

About you

Do you smoke?
Have you ever had a blood clot, stroke, heart disease or cancer?
Do you have migraines?

About your HRT

There are 2 main types of HRT. Which type are you taking?

HRT regimes

What type of HRT regime are you on?

Cyclical HRT questions

How long have you been on cyclical HRT?
Have you had any abnormal bleeding with your cyclical HRT? This would include bleeding after sex, bleeding in between your periods, change in bleeding pattern.
Please contact the surgery on 01786 822595 to make a GP appointment a face to face HRT review.

 

Continuous HRT questions

Have you had any bleeding on your continuous HRT?
Please contact the surgery on 01786 822595 to make a GP appointment a face to face HRT review.

 

Your HRT preparation

How do you receive your HRT?

Your oestrogen dose

Benefits and risks of HRT

Please take some time to read about the benefits and risks of HRT by clicking on the link below:

HRT benefits and risks

This will open a new window and will allow you to come back to this form to continue.

Please confirm you have read about and understand the risks and benefits of taking HRT

Next Steps

We will need to text you after reviewing your HRT form and will use the mobile number on your medical record. If we do not have a mobile number for you (or you have recently changed mobile number), please fill in our change of contact details form below:

Change your contact details

Are you requiring a prescription of your HRT to be printed and sent to your nominated pharmacy? If we do not have a nominated pharmacy on file, by default prescriptions are sent to Well Place across the road from the surgery.

Privacy Policy

This form collects your name, date of birth, and other personal information and medical details. This is to confirm your are registered at this practice, to allow the practice team to contact you and also to update your medical record held by the practice. Please read our Privacy Policy to discover how we protect and manage your submitted data.