Moyle Medical Centre

Old Glenarm Road | Larne | County Antrim | BT40 1XH

Oral Contraceptive: Annual Pill Check

It is important to complete an annual pill check to ensure it is still safe for your GP to continue to prescribe this medication for you. *This form is only to be completed by those patients who are currently prescribed the oral contraceptive pill (combined pill OR progesterone only pill) and have been prescribed this pill within the last 12 months.* 

Long Acting Contraception

If you are interested in longer acting contraception such as the implant or the coil you can read more information on these options by clicking the link above: Contraception (Types, Benefit, and Side-Effects). If you wish to proceed with the contraceptive implant you can contact either Inver Surgery OR family planning to discuss this further. If you are interested in the coil please contact the local family planning service at 028 2826 6163.

Notes:

Please inform your doctor if you develop any new conditions so they can check it is safe for you to continue to take your pill.

If you go into hospital for an operation or have an accident which affects your mobility or movement of your legs, tell the doctor you are taking the pill as you may need to stop the pill OR need other treatment to reduce the risk of developing thrombosis (blood clots). There are other contraceptive methods available in this situation.

Oral Contraceptive: Annual Pill Check
This is required in case the Doctor/Nurse/Practice Pharmacist wants to contact you regarding the information in the completed form
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You can check your blood pressure at the BP machine by the front door of the surgery, at a local Pharmacy, or at home if you have access to a home monitor.

Please tick Yes or No to the following questions:

(If you do have any concerns please ring the surgery to organise a call back to speak with a Doctor.)
(Aura is when there is specific warning signs just before the migraine begins, for example visual disturbance)
(Called a DVT/deep vein thrombosis OR a PE/pulmonary embolus.)
(Called a DVT/deep vein thrombosis OR a PE/pulmonary embolus.)
(Information on this can be found on the Family Planning Association website. If you are unsure or would like to consider the morning after pill you can contact your local Pharmacist under the minor ailments scheme.)

Please read the following symptoms carefully: If you develop...

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