Hypothyroid Self Assessment Form

For many people with an underactive thyroid (Hypothyroidism) taking thyroxine medication this is a simple process of taking a standard and stable dose of pills every day for life.  Providing you are well and stable we may be able to monitor your health with an annual blood test and answering a few questions, saving you time, and us some appointments for other patients needing to see us.

If this applies to you (and you are not on any other tablets requiring monitoring), then before your medication runs out please fill in this form and submit and we will review whether we can “automatically” review your medication for another 9-12months.

Obviously if you are not well we want to see you to assess the situation

Hypo-thyroid Self Monitoring Form

Please enter your date of birth as dd/mm/yyyy
What is your weight (ideally in kg)
If it is less than 60 or above 80 when resting please discuss this with your doctor