Depo Contraception Repeat Questionnaire

If you require a repeat of your depo injection, please submit this form.

Appointments will be booked directly on receipt of this form unless the injection is overdue and for clinical review.

Depo Contraception Repeat Questionnaire

Depo Contraception Repeat Questionnaire


Depo should be given every 12 weeks - it can be given up to 14 days late. Is your injection overdue? *
Have you had unprotected sex since your last injection ran out?

Please note, the contraceptive injection does not protect against sexually transmitted infections.

The depo injection is associated with a loss of bone mineral density. Please discuss this at your appointment if you have any questions/concerns about this.

Other methods of longer acting contraception include the contraceptive implant and the intrauterine device (coil), which can both be fitted at the surgery. Would you like more information about these alternatives?