Use this service to submit a review of your medication.
You can use this service if you:
- are registered at the surgery
- have been invited to do so
Important: Please note
This form is only to be completed if you have been invited to do so by the practice. If you have not been invited to complete this form and you have an issue with one of your medicines, please contact the practice.
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
Call 999 or go to A&E now for any of these:
Signs of a heart attack
chest pain, pressure, heaviness, tightness or squeezing across the chest
Signs of a stroke
face dropping on one side, can’t hold both arms up, difficulty speaking
Sudden confusion (delirium)
cannot be sure of own name or age
Suicide attempt
by taking something or self-harming
Severe difficulty breathing
not being able to get words out, choking or gasping
Heavy bleeding
spraying, pouring or enough to make a puddle
Severe injuries
after a serious accident
Seizure (fit)
shaking or jerking because of a fit, or unconscious (can’t be woken up)
Sudden, rapid swelling
of the lips, mouth, throat or tongue
Labour or childbirth
waters breaking, more frequent intense cramps (contractions), baby coming, or just born
British Sign Language (BSL) speakers can make a video call to 999.
Deaf people can use 18000 to contact 999 using text relay.
You can also phone us on 01603 437 559.