Request to join the contraception waiting list

Have you been advised by the surgery to arrange this appointment? *

Yes

No

What appointment type do you need?

Implant removal

Implant insertion

Implant removal and insertion

Coil insertion

What current contraception do you use, if any? *

Confirmation *

I confirm that my enquiry is not urgent, and that I am happy to be added to the waitlist to be contacted by the contraceptive GP to discuss my options.

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