Testing Do Not Use

It’s important that your medical records are up to date and that you inform us if you have stopped taking any repeat medication. Please use this form to tell us if you are no longer taking a medication and the reason why.

About You

Please use this date format: DD/MM/YYYY.

We will only use this email address for correspondence in relation to this request and will not sell it onto third parties.

Stopping Repeat Medication

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

Repeat Medication Stopped

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