Antidepressant Medication Review

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Date of birth *

Please use format day/month/year e.g. 12/05/1979

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Have you read and understood about the long term issues of antidepressants use? *

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Do you want to continue with your antidepressant over the next 6 months? *

Yes

No

Would you like to speak to a clinician about your antidepressant? *

Yes

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Please provide a brief summary of your mental health recently: *

Which Barclay Medical Practice are you registered with?

East Craigs Barclay

Livingston Barclay

Fauldhouse Barclay

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