Medication review

Please complete this confidential questionnaire before you attend for your blood test.

1

We need the following information before we can issue a prescription of your HIV tablets

Have you used any recreational drugs, club drugs/chems or poppers in the last six months? *
Are you allergic to any medication? *
Are you having any problems with your HIV medication? *
Please tell us how you would like to receive your medication: *
Sexual Health Dorset