Request form

This request page is only for patients currently attending the menopause, POI or PMS clinic.

Important note: There is a national shortage of many HRT products that is out of our control. While this problem persists, please see the British Menopause Society website for alternative HRT options and our GP information and advice leaflet on the Resources and further information page. We have no additional information or advice beyond this.

  • Repeat prescriptions: You may request a repeat prescription for the following medication only—Testogel 50mg/ml, Tostran gel 2%, Decapeptyl 11.25mg, Zoladex 10.8mg. We will phone you to confirm your prescription is still needed.
  • New orders for investigations: These can be requested if you missed your radiology appointment (ultrasound or bone density scan-DEXA) or a blood test was agreed at the last appointment but the order was not made. 

NB: requests are now paperless, just give your name and date of birth or hospital number on arriving in the Phlebotomy (Blood Tests) Department.

  • GnRHa injection appointment: If you need an injection urgently in the next 2 weeks and do not have an appointment, please use this form.
  • Appointments: This form is not to request or change routine appointments. Please contact the case manager in the appointment team on 020 3315 3236.
Date of birth   To confirm your identity
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Reason for contact  

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Please allow 5 working days for your request to actioned. We will only contact you on the supplied phone number if we need to clarify your details or request. Messages will not be answered during public holidays and planned service closure. See closure dates here.

Forms are no longer required for a blood test. Once we have confirmed your request,  please attend the blood test department and you will only need to give you name and hospital number or date of birth.