Medication
Review Form

Antidepressant

Make an Appointment

Request an Appointment Online

Antidepressant Medication Review Form

Required fields are marked with an asterisk (*).

Name

First

Last

Date of Birth*

Email address*

What is the name of your medication?*

Please describe below any new or ongoing side effects on your current medication *

How well do you feel the medication is helping with mood and anxiety levels? (for example- mood swings/ suicidal thoughts/ self-harm/ none)*

How do you manage with day to day activities ? Specifically, Please describe, in the last few months, how much does your condition currently affect your work and home life*

Do you wish to continue with the current regime?*

Do you wish to change the dose?*

Do you want a conversation to discuss coming off the medication?*

Privacy Consent – This form collects personal and medical information 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 submitted data.

I consent to the practice collecting and storing my data from this form

Are you human?*

This field should be left blank

We're here for you

Mental Health Resources

Access Service for Mental Health

Information, help and guidance in relation to mental health

Mental Health Resources

Directory of information and support for your mental health

Other forms available

Register as Patient

Please visit our Patient Registration page and fill in the health questionnaire to register as a patient at Teldoc.

Change of Contact Details

If you need to update your email or contact number, then please use this form

More Self-Referral and Review Forms

Visit here for more self-referral, review forms and services

More forms

Please visit the How Do I Portal for more forms

Find out more...

https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2023/05/card_image_07.jpg

Latest News at the Surgery

All the latest news from Shifnal & Priorslee Medical Practice, the NHS and other health services

https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2021/07/card_image_01.jpg

Vaccination Information

All the latest vaccination clinic dates and locations and latest vaccination news from Teldoc PCN and NHS

https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2023/05/card_image_14-1.jpg

Visit the How Do I Portal

Visit the How Do I portal for information on how to make an appointment, register at the practice and change your details

Register for Online Access

Online Services

Shifnal & Priorslee Medical Practice

Quick Links

Connect

01952 460 414

Haughton Road, Shifnal, Shropshire, TF11 8DD

Gatcombe Way, Priorslee, Telford, TF2 9GZ

Inspected and rated

©2025 Teldoc Primary Care Network. All rights reserved. Site design by JC @ Privilege

error: Content is protected !!