Do you consent to the practice contacting you by text message for appointment reminders, invitations to health checks, vaccinations reminders and anything else relevant to your healthcare?

We have an electronic method of contact available for patients to contact the surgery for non urgent requests - do you consent for us to correspond with you via this method and supply us with a preferred email address for this purpose?

Heart Disease?

Stroke?

Cancer?

Please give details of any medication which you take (prescribed or otherwise). Please enter each drug on a separate line.

Do you have any allergies?

Do you need / have anyone who looks after you or your daily needs as a Carer?

If Yes, would you like them to deal with your health affairs here?

Do you care for anyone else?

Have you been registered here previously?

Have you moved to the UK from abroad?

Have you had a blood transfusion before 1996?

Have you ever served in the Armed Forces?