Shephall Health Centre > Services > Forms > Health Review Forms > DOAC (Direct Oral Anticoagulants) Review Form

DOAC (Direct Oral Anticoagulants) Review Form

Apixaban, Rivaroxaban, Dabigatran and Edoxaban are blood thinners that are used in many medical conditions. We need to review this medication once a year.

Step One

Complete the eReview below.

Step Two

Arrange to have your “DOAC” bloods taken.

Step Three

We will review your records and conatct you with any changes to your medication in the next few weeks.

Things to know about DOAC:

If you miss a dose, take it as soon as you remember, but don’t double up on the total daily dose
If you suffer a head injury, have blood in your urine, black stools or unexplained bruising, please seek medical advice
It is important that you check with a pharmacist before starting any new medicines or stopping any existing one
You must let other healthcare professionals treating you know that you are taking a DOAC.

DOAC (Direct Oral Anticoagulants)

First Name *

Last Name *

Email *

Enter Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

What is your weight ? *

Please provide weight in kilograms (kg)

What is your height ? *

Please provide height in centimetres (cm)

Do you have any additional comments to make?

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This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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