"Unprofessional Anti-coagulation Visit Sheet"

I see a Health Care Assistant or Nurse for an INR test to measure the time my blood takes to clot. Each time s/he fills up a form ('Visit Sheet') consisting of 6 questions. They include Any increased emotional stress? YES/NO, and Any problems or concerns about their warfarin treatment? YES/NO. S/he always circles NO but never says or asks anything about either stress or concerns I may have about the effects of Warfarin. These parts of the form are filled in mechanically without discussion. It is unreasonable, in my view, to expect staff to judge if my 'stress' has got worse recently when the appointment is only for 5 or 10 minutes and without acknowledging or mentioning stress at all. I read on the Internet there is evidence that psychological stress can elevate INR level but no one at Park End Surgery has ever told me this. If Park End does not really accept this theory but is forced to use a standard form imposed on them by the Clinical Commissioning Group or some other authority, then the integrity of the staff is being put at risk. It would never have occurred to me that staff were stating on a form that I am not experiencing increased stress if I had not seen these completed forms in my medical record online. Acute or chronic stress can affect mental health and survival and be very difficult to talk about and is poorly defined, so I am dismayed and shaken it is not being taken more seriously. Park End's way of working , as far as this Visit Sheet is concerned , belongs to a bygone era when patients had no idea what was written about them in their file. In the past I reported 3 or 4 fears I have about possible adverse effects of Warfarin on my body, so it is quite untrue I have 'no' concerns. Park End seems not to have any system for highlighting on the medical file the patient's perceived problems and questions regarding a particular treatment. If I do raise a problem it may disappear into the dustbin of history and is never reviewed or referred to again by the Surgery. Park End has a high concentration of people with atrial fibrillation. Could the Practice try to find out through its Patient Participation Group if other patients feel the same way about the Visit Sheet? I would want to recommend to others the staff's personal style, but their handling of the Visit Sheet needs to be questioned. Finally, better to replace the ridiculous question about increased emotional stress with a question about bleeding and bruising.