In order to provide another prescription of your contraceptive pill we need to ask you a number of questions.
- This form is not to be used if you have not started the contraceptive pill already or have recently had a break from your usual pill.
- If you are having problems with your contraceptive pill or would like to switch to a different pill or other method of contraception, please do not use this form and book an appointment to see one of our nurses.
- This form is only to be used by women aged 16 years or older.