We provide sexual health, contraception and HIV services in London and Surrey

Do you want a sexual health check or contraception?

1. Where do you live? Please select Haringey Kensington and Chelsea Hammersmith & Fulham Westminster Surrey Elsewhere
2. How old are you? I am under 25 years old I am 25 or older
3. Are you? Male Female
4. So we can direct you to the right clinical service, please tell us if you identify as trans? Yes No
5. Would you like a check-up for STIs (sexually transmitted infections)? Yes No
6. Do you have any symptoms or have you been in sexual contact with someone with an STI? Yes No
7. Who do you have sex with? Men Women Men and women
8. Would you like to start, continue or change a method of contraception or find out more about these?

   We offer free condoms at all of our services.

   Our contraceptive services include pill, patch, injection, diaphragm, nuvaring, and fitting and removal of implants and IUC ('coil').

   Long acting reversible contraception (LARC) is the most reliable method of contraception for an extensive period of time without you having to remember to take or use them in order for them to work. It includes injections, intrauterine contraception (IUCs) and subdermal contraceptive implants (e.g. Nexplanon).

   Yes No
9. Do you want Long-acting reversible contraceptives (LARC)? Yes No
10. If you only want an STI check-up, you can either order a home self-test kit or make an appointment. If you are a woman and want to start, continue or change a method of contraception, please make an appointment to come in to see us. What would you like to do?

    If you are a woman and regard yourself to be someone at high risk of infection you may prefer to attend clinic to discuss additional testing (+/- vaccination if in high risk group)

    Order a home self-test kit Make an appointment at a clinic
11. Are you 18 or over? Yes No
12. Home self-test kits are available for Chlamydia, Gonorrhoea, HIV and Syphilis.

    Your test today may not cover recent risks.

    The best time to test is:

    • Chlamydia and Gonorrhoea: 2 weeks after risk
    • HIV and Syphilis: 4 weeks after risk

    Your results give no indication of your partner's sexual health. You should encourage your partner to test too.

    We will post your kit to you. You take your own samples and send it back. You’ll get your results by text or we will call you.

    We can only offer home self-test kits to people who live within the Surrey County Council area.

    
    Please enter your post code so we can check if you are eligible for this service.
    Check Postcode
13. Our home self-test kits for men include a urine test for Chlamydia and Gonorrhoea.

    Some men may need additional tests.

    If you have had anal sex or oral sex with a man, we will also include swabs (like a cotton-bud).

    We automatically include a finger prick test for HIV and Syphilis if we think you need one based on your answers. You can also choose to add this.

    The next two questions will help us to work what you need.
    Your answers will be confidential.

    If this is your first sexual health check, please answer these questions about all of your sexual experiences.

    If you have had a sexual health check before, please answer these questions based on what has happened since the last time you had a sexual health check.

    
    
    Our home self-test kits for women include a vaginal swab for Chlamydia and Gonorrhoea.

    Some women may need additional tests.

    If you have had anal sex or oral sex with a man, we will also include swabs (like a cotton-bud).

    The next two questions will help us to work out if you need swabs and which ones you need.
    Your answers will be confidential.

    If this is your first sexual health check, please answer these questions about all of your sexual experiences.

    If you have had a sexual health check before, please answer these questions based on what has happened since the last time you had a sexual health check.

    
    
    Have you had a penis (or a shared sex toy) inserted in to your bum?

    We are asking this so that we know whether you need a swab for your rectum.

    Yes No
14. Have you sucked a penis?

    We are asking this so that we know whether you need a swab for your throat.

    Yes No
15. We can test your blood for HIV and Syphilis using a finger prick test.

    If you have not had an HIV test before, we recommend you have one. We also recommend regular testing for people who are at higher risk.

    If you are not sure whether you need an HIV or Syphilis test or you want more information about HIV testing, visit this page.

    You can do this now because you will be able to come back to this form once you’ve read the information.

    Do you want a finger prick test for HIV and Syphilis? Yes No
16. Choose your type of contraception

    For information on the best types of contraception for you click here

    For most methods of contraception you will need to have a consultation with one of our clinicians. However some methods are also available online to Surrey residents who are aged 18 or over, these are:

    • the progestogen only pill (POP) and,
    • for patients who are currently being prescribed the method from one our clinics, the combined hormonal contraceptive pill (COC).

    If you choose online contraception, we will ask you a number of health related questions to assess your suitability for this service as would happen in a clinic appointment. Your answers will be reviewed by a doctor. All prescriptions are free and will be sent by tracked delivery, you will not have to sign for this. The prescription will be issued on the understanding it is for your use only and for contraceptive purposes.

    An appointment is required for, Intrauterine devices and systems, subdermal implant, depo injection, transdermal patch, vaginal ring, vaginal diaphragm.

    If you’re sexually active you might also want to have a regular sexual health check-up. We now offer this online at www.sexualhealth.cnwl.nhs.uk/surrey-kits

    Clinic appointment (All types) Online Contraception (Pills only)
17. Are you 18 or over? Yes No
18. Currently Online Contraception is only available to women with a Surrey County Council area postcode.

    Please enter your postcode so we can check if you are eligible for this service.

    Check Postcode
19. Type of Contraception

    Please choose whether you would like a prescription for the progestogen only pill (POP) or combined oral contraceptive pill (COC).

    Progestogen only pill Combined oral contraceptive pill
20. Are you currently taking the progestogen only pill? Yes, I want a repeat prescription No, I wish to start the progestogen only pill

21. The progestogen-only pill (also known as ‘POP’ or ‘mini pill’) is a small tablet that contains a progestogen hormone. It works by thickening the cervical mucous stopping the sperm meeting the egg and, in some women, it also stops ovulation.

    Effectiveness: With perfect use about 1 in 100 women will get pregnant each year, however, for typical use about 9 in 100 women will get pregnant each year. This is because in typical use people forget pills or might do something else that makes it less effective. It becomes effective 48 hours after taking your first pill.

    Advantages: Medically the POP is very safe, there are very few contraindications and risks. Whilst it is a good contraceptive for women of all ages, it is ideal for women who can’t take oestrogen or are older.

    Disadvantages: You may not get a regular bleed with this method, whilst some women may experience no bleeding others may experience bleeding at irregular intervals.

    Use: The POP is taken daily, you do not take a break between packets. Most POPs have to be taken within 3 hours of the same time each day, except one that contains desogestrel which has to be taken within 12 hours of the same time each day. We supply both, but if you are a new customer we will supply the desogestrel POP.

    Please read further information here

    
    

    We need to check that there is nothing in your medical history that might make it unsafe to use the POP

    Online prescription of POP is offered only to women below the age of 55.

    What is your current main method of contraception? Please select Condoms Withdrawal Combined pill (COC) EVRA patch Nuvaring Progestogen only pill (POP) Implant Injection IUD IUS Diaphragm Natural family planning Not sexually active Other

    Please enter any details.

    Continue
22. Do you think you might be pregnant? Yes No
23. Have you had any unexpected vaginal bleeding? Yes No
24. Have you had sex without reliable contraception in the last three months? Yes No
25. Have you used emergency contraception in the last three months? Yes No
26. Are you taking any medication that you have been prescribed or bought? Yes No

    Please enter any details.

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27. Are you taking St John’s wort? Yes No
28. Do you have any allergies (including peanut and soya allergies)? Yes No

    Please enter any details.

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29. Have you ever had any of the following conditions:
    • high blood pressure
    • diabetes
    • breast disease
    • cancer of any type
    • venous or arterial thrombosis
    • stroke (or TIA)
    • heart disease
    • liver disease, jaundice or gall stones
    • high cholesterol
    • antiphospholipid antibodies
    • malabsorption syndromes
    • gastrointestinal surgery
    • restricted mobility
    Yes No
30. Have you had any other serious illnesses or operations? Yes No

    Please enter any details.

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31. The progestogen-only pill (also known as ‘POP’ or ‘mini pill’) is a small tablet that contains a progestogen hormone. It works by thickening the cervical mucous stopping the sperm meeting the egg and, in some women, it also stops ovulation.

    Effectiveness: With perfect use about 1 in 100 women will get pregnant each year, however, for typical use about 9 in 100 women will get pregnant each year. This is because in typical use people forget pills or might do something else that makes it less effective. It becomes effective 48 hours after taking your first pill.

    Advantages: Medically the POP is very safe, there are very few contraindications and risks. Whilst it is a good contraceptive for women of all ages, it is ideal for women who can’t take oestrogen or are older.

    Disadvantages: You may not get a regular bleed with this method, whilst some women may experience no bleeding others may experience bleeding at irregular intervals.

    Use: The POP is taken daily, you do not take a break between packets. Most POPs have to be taken within 3 hours of the same time each day, except one that contains desogestrel which has to be taken within 12 hours of the same time each day. We supply both, but if you are a new customer we will supply the desogestrel POP.

    Please read further information here

    
    

    Online prescription of POP is offered only to women below the age of 55.

    What is the name of the POP you are taking?
    Continue
32. Are you finding it difficult to remember to take the pills on time? Yes No
33. Have you been late or missed taking any pills in the last three months? Yes No
34. Do you think you might be pregnant? Yes No
35. Have you used emergency contraception in the last three months? Yes No
36. Have you had any unexpected vaginal bleeding? Yes No
37. Are you taking any medication that you have been prescribed or bought? Yes No

    Please enter any details.

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38. Do you have any allergies (including peanut and soya allergies)? Yes No

    Please enter any details.

    Continue
39. Are you taking St John’s wort? Yes No
40. Have you ever had any of the following conditions:
    • high blood pressure
    • diabetes
    • breast disease
    • cancer of any type
    • venous or arterial thrombosis
    • stroke (or TIA)
    • heart disease
    • liver disease, jaundice or gall stones
    • high cholesterol
    • antiphospholipid antibodies
    • malabsorption syndromes
    • gastrointestinal surgery
    • restricted mobility
    Yes No
41. Have you had any other serious illnesses or operations? Yes No

    Please enter any details.

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42. In the last 12 months which CNWL service did you use for the COC?

    COC is available online only to women who are currently receiving this method from either a CNWL sexual health clinic or CNWL online service. (We will check this against our records)

    Please select Buryfields Clinic Earnsdale Clinic Woking Clinic Leatherhead Hospital Derby Medical Centre in Epsom Stanwell Health & Community Centre Addlestone Youth Centre Staines Clinic Crowther Market Raymede Clinic Woodfield Road Medical Centre Bessborough Family Hub Imperial College Health Centre Mortimer Market Centre / Margaret Pyke Centre Archway Centre Edgware Community Hospital Vale Drive Primary Care Centre Crowndale Health Centre Gospel Oak Health Centre Grahame Park Health Centre Morum House Medical Centre Lordship Lane Health Centre CNWL online service None of the above

43. The combined oral contraceptive pill (also known as ‘COC’) is a small tablet that contains a progestogen and oestrogen hormone. It works by stopping you ovulating (producing an egg).

    Effectiveness: With perfect use about 1 in 100 women will get pregnant each year, however for typical use about 9 in 100 women will get pregnant each year. This is because in typical use people forget pills or might do something else that makes it less effective. It becomes effective 7 days after taking your first pill.

    Disadvantages: There is a very small increased risk of venous thrombosis and stroke when using this pill, the medical history you provide us with will assess whether you are at increased risk and therefore should not use an oestrogen containing contraceptive. The COC increases the risk of heart attacks, breast cancer and cervical cancer.

    Advantages: This method gives very predictable bleeding patterns and makes bleeds less heavy. You can take it continuously and take a break when you want a bleed. It can also improve acne in some women. The COC also reduces the risk of endometrial, ovarian and bowel cancer.

    Use: The COC is usually taken daily, with a seven day break each month. However, not taking a break may increase the effectiveness, as does reducing the break between packs to 4 days. This is safe to do and reduces the number of bleeds you have.
    It has to be taken within 24 hours of the same time each day.

    
    

    We need to check that there is nothing in your medical history that might make it unsafe to use the COC

    Please read further information here

    You will need to provide your height, weight and blood pressure as part of this process.

    Online prescription of COC is offered only to women below the age of 50

    What is the name of the COC you are taking?
    Continue
44. Have you been pregnant in the last 6 months? Yes No

    Please enter any details.

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45. Are you finding it difficult to remember to take the pills on time? Yes No
46. Have you been late or missed taking any pills in the last three months? Yes No
47. Do you think you might be pregnant or have you had any unexpected bleeding? Yes No
48. Have you used emergency contraception in the last three months? Yes No
49. Are you taking any medication that you have been prescribed or bought? Yes No

    Please enter any details.

    Continue
50. Do you have any allergies (including peanut and soya allergies)? Yes No

    Please enter any details.

    Continue
51. Are you taking St John’s wort? Yes No
52. Have you ever been advised not to take oestrogen containing medication? Yes No
53. Have you smoked any cigarettes, tobacco or vaped in the last 12 months? Yes No

    Please enter any details.

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54. Have you ever had any of the following conditions:
    • high blood pressure
    • diabetes
    • breast disease
    • cancer of any type
    • venous or arterial thrombosis
    • stroke (or TIA)
    • heart disease
    • liver disease, jaundice or gall stones
    • high cholesterol
    • antiphospholipid antibodies
    • malabsorption syndromes
    • gastrointestinal surgery
    • restricted mobility
    Yes No
55. Have you had any other serious illnesses or operations? Yes No

    Please enter any details.

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56. Have you ever had a migraine? Yes No
57. Has anyone in your close family, (mother, father, brother, sister) had, breast cancer, heart attack, stroke, thrombosis, if so how old were they, or do any of these conditions run in your family? Yes No

    Please enter any details.

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58. Have you seen any other contraceptive provider since your last prescription from Surrey Sexual Health and if so what for? Yes No

    Please enter any details.

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59. What is your weight

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60. What is your height

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61. Body mass index

    Your BMI is

    
    What is your blood pressure (XXX/XX)

    You can measure your blood pressure at many places across Surrey. Many GPs and high street chemists offer this service. You can also buy blood pressure monitoring devices from shops.

    If you cannot find a convenient blood pressure device feel free to walk-in to one of our clinics in Guildford, Woking or Redhill: details are on our website.

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