• You have been provided with this form to please complete and return back to the GP surgery (as per the below instructions) because you are due your annual medication review.
  • Please complete this form to the best of your ability and date and sign the bottom to ensure we take the most appropriate action for you in regards to your medication.
  • If further information/ follow-up is required, then you will be contacted in due course. Otherwise, we will use the below information to update your repeat medications (if possible) going forward. 

Thank you in advance for your cooperation.

Stop Smoking Support

FREE advice and support to help you stop smoking can be obtained from the NHS service “Help Me Quit”.

More information can be found at https://www.helpmequit.wales/ or by calling 0800 0852219