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Home > 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.

Once you have completed this form please contact us for the DOAC blood tests.

Once the clinician has your form and blood results they will review the information and contact you if any changes are needed.

Important information for patients on Direct Oral Anticoagulants:

  • Inform any health professional that you are on this medication.
  • If you have a head injury, see blood in your urine, have black stools or unexplained bruises see medical attention.
  • If you start any new medication, change or stop an existing one please speak with the clinician / pharmacist and make sure they know you are on Direct Oral Anticoagulants.
  • Don't double up on a dose if you miss one.  Take the missing dose as soon as you remember to.
Your Details
DD/MM/YYYY

One of the clinicians will call you on the number provided in the next couple of weeks

Review Questions
Specify if in kg or stones / lbs
Specify if in cm or ft / in

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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Ongar War Memorial Medical, Fyfield Road, Ongar, Essex, CM5 0AL

  • 01277 367200
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