Prescription request form
Prescription request form
For existing Menopause Care patients

Who can use this form?
If you require a prescription outside of a consultation, please complete the form to submit your request.
Please note we can only prescribe if your follow up reviews are up to date. If you are unsure, please book a follow up appointment instead.

YES® intimate health products
We also offer the YES® product range, designed to support intimate and vaginal health as part of menopause and perimenopause care.
Prescription Request Form
Use this request form to submit your request for your prescriptions and YES products.
There is currently a nationwide shortage of Estradot patches.
Our partner pharmacies aim to keep all strengths of Estradot patches in stock. However, due to ongoing supply fluctuations, there may occasionally be temporary interruptions in availability of certain strengths.
If your usual dose is unavailable:
1) we may prescribe a combination of patches to achieve the correct dose, or
2)we may suggest a suitable alternative brand.
Please submit your request as usual.
Our team will contact you if any changes are needed before the prescription is issued.