This form is to be used for the following reasons:
- If you would like to start a new HRT or switch to a different HRT (will also need to complete an e-consult)
- If you want a repeat of your current HRT
- If you have been advised by a clinician to complete this form
Once this form is completed it is passed to a clinician to review. Once issued you will receive a text to collect your prescription at your nominated pharmacy. Please ensure your nominated pharmacy is up to date – please call reception to do so.
You should get a response within a week, if you do not hear anything please call reception.
For information on HRT including types of HRT, risks and benefits and side effects please see these useful links: