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Please only fill out this form if you have been asked to by the practice. This questionnaire is for routine annual review of your HRT. Please complete the form to the best of your ability and when you are happy with all your answers, click submit below and the questionnaire will be automatically sent to the practice. Depending on your answers, you will be contacted if you need to be seen in the practice for a further assessment. Should your symptoms change, please seek medical advice and book an appointment if required.