HRT Medication

For new starters and continuation. Please complete this form and contact the Practice after 72 hours to check if your prescription is ready (this does not include weekends/bank holidays)

Last Updated: 17/05/2022

HRT Medication Review










IF YOU HAVE NOT BEEN ON HRT MEDICATION, PLEASE COMPLETE SECTION 1&3

IF YOU HAVE BEEN ON HRT MEDICATION PLEASE COMPLETE SECTION 2&3

HRT QUESTIONNAIRE - PART 1

Please complete this section if you have NOT been on HRT medication before.











HRT Questionnaire - Section 2

If you are already prescribed HRT medication, please complete this section












HRT Questionnaire - Part 3















Consent Section