Contraceptive Pill - Repeat Prescription Request

There may be an increased risk of blood clots if you are on a combined contraceptive pill (containing oestrogen) AND you experience severe symptoms of COVID-19 infection, requiring bed rest.  If you have had COVID-19 in the last 3 months, or develop it at any stage whilst you are on an oestrogen containing contraceptive, please contact a GP for advice.  Do not stop your contraceptive without talking to a GP.

This form is for the repeat prescription of the oral contraceptive pill.

We will process your request for a prescription in the next 5 working days. If you would like your prescription to be sent to a pharmacy, this will also need to be entered into the form, or inform the receptionist.

It is important to know what to do if you ever miss / forget to take one of your pills. NHS can talk you through what to do If you are ever in doubt please speak to a GP or pharmacist for advice the same day.

Remember that the contraceptive pills do NOT protect against sexually transmitted infections (STIs), using condoms in addition to your pill will reduce your risk of catching an STI.  See for more information

There are other long acting methods of contraception available, if you would like to discuss please book to see the practice nurse or see

Contraceptive Pill - Repeat Prescription Request
Questionnaire For Repeat Prescription Of The Oral Contraceptive Pill

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