Radcliffe Medical Practice

0161 724 2062

Secondary telephone

0161 724 2063

Online Pill Check

If you take any of the oral contraceptive pills you will need an annual review (pill check) at least every twelve months before we can re-authorise your prescription.

This form will allow you to complete the pill check online. We have set up the online pill check with the aim of making it quicker and easier for you to renew your prescription if your pill is suiting you and you wish to continue it. If you are having any problems or concerns, or would like to discuss other forms of contraception, we would be more than happy to hear from you. Please book an appointment with one of our practice nurses.

To fill in this form you will need your current height, weight and blood pressure.

The pill check will be sent to the practice team and your request will usually be processed within 2 working days. If there are any issues we will contact you to discuss further.

Online Pill Check

Your Details

Please enter your blood pressure in the XX/XX format.

Your Pill Check

Are you experiencing any problems with bleeding after sex or bleeding between periods(Required)
If you answered yes to this question then please arrange an appointment with one of our clinicians.
Are you on any other medication in addition to your pill?(Required)
Have you been diagnosed with any new health conditions since we last issued you a prescription?(Required)
Do you smoke?(Required)
If you answered yes to this question please answer the next 2 questions.
Would you like help/advice on how to stop smoking?
Do you drink alcohol?(Required)
If you answered yes to the above question then please also answer this question.
Do you suffer from migraine headaches?(Required)
Aura is when there are specific warning signs just before the migraine begins, for example a change in your vision. It is vital you do not take combined oral contraception if you have migraine with aura, as this is known to increase your risk of stroke. If you are uncertain please contact the surgery to discuss(Required)
See The Migraine Trust Information for more clarification: https://migrainetrust.org/understand-migraine/types-of-migraine/migraine-with-aura/
Have you ever had a blood clot?(Required)
For example in your leg or in your lung, often referred to as a DVT or a PE.
Has a close family relative (parent or sibling) ever had a blood clot?(Required)
Have you ever had breast cancer?(Required)
Has a close family relative (parent or sibling) ever had breast cancer?(Required)
Smear tests are an essential tool to prevent cervical cancer. They are offered to everyone with a cervix between the age of 25 and 64. The screening interval is every 3 years for those aged 25-49, and every 5 years for those aged 50-64. You will receive an invitation to book from the national screening service if you are due. Are you up to date with your cervical screening?(Required)
If you have received an invitation or if you believe you are due for your smear test after reading the above information, please contact the surgery to arrange an appointment. For more information on cervical screenings please visit https://www.nhs.uk/conditions/cervical-screening/
Are you aware that there are more reliable, long-acting methods of contraception available?(Required)
You should be aware of other, more reliable long-acting methods of contraception, such as the Coil or the Implant. These methods of contraception can last 3-5 years and are more effective than any oral contraception. If you wish to discuss alternative contraception please arrange an appointment with our practice nurse.
You should be aware that no contraceptive pill protects against sexually transmitted infections. Full sexual health screenings and self swabs are available locally.(Required)
For more information on local sexual health clinics please visit our website.
If you miss a pill, you may be at risk of an unplanned pregnancy. The rules for missed pills can differ depending on which pill you are taking. For more information this please visit https://www.nhs.uk/conditions/contraception/miss-progestogen-only-pill/ or https://www.nhs.uk/conditions/contraception/miss-combined-pill/.(Required)
Your health and safety is important to us and we need to ensure that we have sufficient information to complete this review. If at any time you have concerns regarding your pill then please speak to one of our clinicians.(Required)
Privacy Consent(Required)

Thank you.