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Foundation Surgery NHS GP surgery

Hypothyroidism review

Hypothyroidism

Form summary

Weight in kilograms *

For example, 60.6

Pulse *

/min

Have you had any significant change in weight over the last 9 months? *

Intentional weight gain

Unintentional weight gain

Intentional weight loss

Unintentional weight loss

No change in weight

Have you had your blood tested for thyroid in the last 9 months? *

Yes

I’m not sure

Is there anything you would like to discuss? *

Yes

For example, about your hypothyroidism, lifestyle, medication, support

Provide details about what you would like to discuss *

Terms and conditions *

I confirm that this is not an emergency and understand the surgery cannot help while it is closed. If I need help right now, I will use the NHS 111 service. In an emergency, I will call 999 or go to A&E.

If you are human, leave this field blank.

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