Request for medication to delay a period

Request for medication to delay a period
Any medication can potentially have side effects. You need to be aware that the medication used to delay a period carries a small increased risk of blood clots. The risk is similar to the combined contraceptive pill. To help us know if the medication is appropriate for you we need some information. Please answer the questions below. You will also need to give us a recent weight (in kg) and blood pressure reading. You can have your blood pressure checked at most pharmacies, or you can use the blood pressure machine in the waiting room at the Carleton branch.

Then return the form to the reception desk. The form will be checked. Please contact the surgery after 48 working hours to see if the medication has been issued. Usually it will be straightforward. Very occasionally we might need to see you or speak with you.

Thank you

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