Medication Review We review any regular medication on a repeat prescription annually and wherever possible the doctor will do this without you having to attend the surgery. If you have been advised by the surgery that your medication review is due please use this form. Name * First Name Last Name Date of birth * - Day - Month Year Date Tel: * Named GP if known Do you have any concerns or side effects from your medication? * Yes No Do you know when and how to take your medication? * Yes No Are you happy for the doctor to update your review date now? * Yes No Submit Should be Empty:
