Prescription Question Form

Use this service to ask a question about your medication. For example, when to take it and what to do if you miss a dose or about possible side effects.

You can use this service if you:

  • are registered at the surgery

Before you start

We’ll ask you for:

  • if applicable, the details of the person you are completing the form on behalf of
  • your first and last name, date of birth, sex, postcode, email and phone number

What is your name?
DD slash MM slash YYYY
What is your sex?
The one used to register with your GP
Anyone else with access to your email account may see responses sent to you
Consent