Mental Health Medication Review

Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)

Personal Details

Please double check you've entered the correct email address

Personal Alcohol Consumption

How often did you have a drink containing alcohol in the past year?: *

How many drinks containing alcohol did you have on a typical day when you were drinking in the past year?: *

How often did you have six or more drinks on one occasion in the past year?: *

Audit Score Result

You have a score of

If you are drinking less than 14 units of alcohol per week, then your drinking is within the UK Chief Medical Officers' low risk drinking guidelines.

But if you are drinking regularly at or above the low risk guidelines of 14 units a week, or, you are drinking six or more units - if you are female - or eight or more units - if you are male - in one single session (binge drinking), please consider the increased serious risks to your health being caused by your current drinking pattern.

Do you smoke?:

How much do you smoke?:

Do you use recreational drugs?:

Mental Health Medication Review

In order to provide your repeat prescription for mental health medication - antidepressants or anti-anxiety medication please complete this questionnaire

What medication do you require on your repeat prescription?:

Are you under the care of the mental health team at Tameside hospital;:

Are you under the care of our Mental Health Practitioner ?(Stephen Vieties) :

Is your mood stable on this medication?:

Are you aware of the long term side effects of the medication?:

Would you like to continue on with the same dose and type of medication without a GP appointment?:

Are you aware of how to access psychological support/counselling eg, through healthy minds?:

If you have answered NO to the questions above you may require a text, telephone or face to face appointment. Our reception team will be in contact with you if this is the case.

Do you experience any troublesome side effects from the medication?:

Do you experience any thoughts of deliberate self harm or suicide?:

Do you hear voices or see things/images that other people do not see?:

Have your family, friends or work expressed concerns about your mental health and advised a GP review?:

Would you like to discuss reducing the dose or stopping this medication? (This would be advised if you have felt back to normal for 6 months):

Do you feel back to normal?:

Would you like to discuss increasing the dose or adding in additional medication for your mental health?:

If you answered Yes to any of these questions you may require a text, telephone or face to face appointment. Our reception team will be in contact with you if this is the case.

If No appointment is required your medication can be reauthorised for 12 months - or until the next birthday review.

Privacy Consent

This form collects personal and medical informanot tion about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.

Mental Health Medication Review

You have a score of

Privacy Consent

CONTACT DETAILS

QUALITY TEACHING PRACTICE

PRIDE IN PRACTICE: GOLD AWARD

HOMELESS FRIENDLY PLEDGE

APPROVED SAFE SPACE

Functional Cookies

3rd Party Cookies