Asthma Review
If you have been advised by the surgery to submit an annual review of your asthma symptoms please use this form. If your symptoms are deteriorating or you are having any concerns please make an appointment with our Nurse.
Breathlessness Review
If you have been advised by the surgery to submit breathlessness review on a regular basis please use this form.
Epilepsy Review
If you have been advised by the surgery to submit a epilepsy review please use this form.
Alcohol Consumption Review
If you have been invited to submit an alcohol consumption review, please complete this form.
Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired?
This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you.
Use this scale to assess your sleepiness.
Male Urinary Tract (IPSS)
If you have been advised by the surgery to submit Male Urinary Tract (IPSS) review please use this form.
Patient Health Questionnaire (PHQ-9)
If you have been advised by the surgery to submit a Patient Health Questionnaire (PHQ-9) please use this form.
Blood Pressure Review
If you have been advised by the surgery to submit your blood pressure readings on a regular basis, please use this form.
Contraceptive Pill
If you have been advised by the surgery to complete a contraceptive pill review, please use the surgery pod in the reception waiting room anytime during open hours to do so.
Smoking Review
If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.
COPD Assessment
If you have been advised by the surgery to submit a COPD assessment please use this form.
This assessment will help us measure the impact of COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life. Your score will be used by us to help improve the management of your COPD and get the greatest benefit from treatment.
Hypothyroid Self Assessment
For many people with an underactive thyroid (Hypothyroidism) taking thyroxine medication is a simple process of taking a standard and stable dose of pills every day for life. Providing you are well and stable we may be able to monitor your health without you visiting the practice.
If this applies to you (and you are not on any other tablets requiring monitoring), then before your medication runs out please complete this assessment and we will review whether we can repeat your medication for another 9-12 months.
Oxford Knee Score
The Oxford Knee Score is designed to assess function and pain in your knee. Please complete this self-assessment. You will have the option to send your results to your GP at the end.
Please be aware that any replies from the surgery may appear in your Junk Inbox.