The Murray Surgery

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Antidepressant Medication Review Form

We can offer a telephone/video review  rather than having patients attend the surgery unnecessarily. Many people have been taking antidepressants for a long period and are reluctant to stop this medication.

If you are considering stopping the medication please see How should you come off antidepressants?


Antidepressant Medication Review
Please use format day/month/year e.g. 12/05/1979
Do you take it regularly? *
Do you think you need any more help with your mental health at the moment and if so, what do you think would be most helpful? Please tick whichever of the following you think would help
Since your last review, have you had any thoughts that you would be better off dead or any thoughts of hurting yourself in some way?
If so, do you have any current plans to end your life? *

Smoking Review

Do you currently smoke? *
If yes, would you like help to stop?

Your Personal Alcohol Consumption

Units of Alcohol

Your Personal Alcohol Consumption – Part 2

Medication/Drugs

Are you using any non-prescribed drugs or medication?

Eating Habits

Do you have any concerns about your eating habits?

Work

Are you currently

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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