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DRUM

Name:

Practice Postcode:

DOB:

To prevent spam please record the Practice Postcode (PL159HH) below:

Do you understand why you have been prescribed your medication and what it is for?

Do you take your medication the correct way as stated on the label ?

Are any of the medications you are currently prescribed causing you any problems ?

Do you have any difficulties that affect how you take your medication?
E.g. Problem swallowing, removing from container, inhalers etc

Is there any medication on your repeat list that you are no longer taking and can be removed ?

Do you have any medication at home that you are no longer taking ?

Do you have more than 4 weeks supply at home ?

Is further action/help required with any of the above ?

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