Contraceptive implant (Nexplanon) questionnaire

Use this service to request an implant removal and/or insertion.

You can use this service if you:

• are registered at the surgery

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of

Start now

You can also phone us on 0121 353 7558 or visit the surgery in person.