Total Triage System

Since Wednesday 10 January 2024, we are operating a total triage system, where every request for a GP appointment is triaged by our GP team. To request a doctors appointment we are asking all our patients to use an online form where possible. If you find it difficult to use a computer or a smartphone, you can telephone our reception on 020 8669 6186 or attend in person and our receptionists will fill out the form on your behalf. Our reception staff are not able to book an appointment with a GP directly.

Wallington Family Practice > Services > Forms > Health Review Forms > Menopause Symptom Scale (Greene Climacteric)

Menopause Symptom Scale (Greene Climacteric)

The Greene Scale provides a brief measure of menopause symptoms. It can be used to assess changes in different symptoms, before and after menopause treatment. Three main areas are measured:

  • Psychological
  • Physical
  • Vasomotor
Menopause Symptom Scale (Greene Climacteric)
Please use format day/month/year e.g. 12/05/1979

Symptoms

Please indicate the extent to which you are bothered at the moment by any of these symptoms:

Heart beating quickly or strongly:
Feeling tense or nervous:
Difficulty in sleeping:
Excitable:
Attacks of anxiety, panic:
Difficulty in concentrating:
Feeling tired or lacking in energy:
Loss of interest in most things:
Feeling unhappy or depressed:
Crying spells:
Irritability:
Feeling dizzy or faint:
Pressure or tightness in head:
Parts of body feeling numb:
Headaches:
Muscle and joint pains:
Loss of feeling in hands or feet:
Breathing difficulties:
Hot flushes:
Sweating at night:
Loss of interest in sex:
Automatically calculated from the questions above.

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This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.