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Clarendon Lodge Medical Practice
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  • Contact Us

Reception: Contraception Options

There are lots of different methods of contraception available and different types will suit different people.

Methods can be hormonal or non hormonal.

Non hormonal methods include the copper coil and barrier methods, such as condoms or the female diaphragm or condom.

Hormonal methods include pills, a patch, vaginal ring or contraceptive injection. Or there are longer acting methods such as hormonal coils and the implant.

The NHS wesbite below contains lots of useful information about these different methods.

www.nhs.uk/conditions/contraception

Please look through this website and then fill in as much information as possible.

Some of this information will already be included in your medical notes but this is a good opportunity to update any changes.

Please do not write any clinical queries on this form. Any clinical queries or request for appointments via this form will be discarded. To make an appointment either book online via the NHS app/Patient access or by calling reception 01926 331401. We will start to process your form by the next working day but it will take up to 1 working day to complete. Please DO NOT call before 1 working day as you will not receive a status update from reception or the administrative team. If you are NOT a registered patient then your form will be discarded. This service is only for patients registered at the surgery aged 16 and over; and for parents or legal guardians of children. Forms must be completed in the UK due to GDPR regulations. 
Personal details
Current contraception
If yes, what have you used and did it suit you? If it did not suit you please explain why not or what you didn't like.
Health information

Sometimes other health problems or medication can affect the types of contraception that are safe to use. Answering these questions will help us work out which options are best for you.

If yes please let us know if you are breastfeeding
Please tick the box against any conditions you have been diagnosed with:
Please tick the box next to any conditions that are present in your family:
And some final details

Thank you for completing this form


Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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Clarendon Lodge Medical Practice

Clarendon Lodge, 16 Clarendon Street, Leamington Spa, Warwickshire, CV32 5SS

  • 01926 331401
  • enquiries@clmp.nhs.uk (Please do not send clinical queries or attachments to this email address. They will be discarded. Instead use our online forms found on the homepage)
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