Mental Health Medication Review

 
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Personal Details
 
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Lifestyle
Smoking status: *
 
Alcohol consumption:

Each of the examples depicts 1 unit of alcohol based on the Alcohol by Volume (ABV) against the Volume (ml) displayed.

Enter 0 if no alcohol is consumed
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Medication
Do you take any medication?: *

Please list the medications that you take:

How long do you think you will be taking your medication: *
Please choose from one of the following: *

Get advice from NHS 111 Wales or ask for an urgent GP appointment if:

 
  • you need urgent help for your mental health

Get help from 111 online or call 111 and select the mental health option.

You cannot continue with this form: *
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Confirmation

From the responses given, a review with a doctor is recommended. 

Make an appointment for a medication review with a GP

Your medications will be reauthorised and continued. If you have any queries moving forward, please make an appointment to see a GP.

Get mental health support online from NHS 111 Wales. Or call 111 and select the mental health option

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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Bron-Y-Garn Surgery
Neath Road
Maesteg
CF34 9PW

Telephone: 01656 754200

All calls to and from the practice are recorded.

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