Patient Questionnaires and Consent Forms


Better Information Means Better Care Scheme

Please click here to view The Opt Out Form. All completed forms should be returned to The Surgery where they will then be added to your patient record, indicating you do not wish your medical record shared.


SMS / Text Messaging Consent

mobile phoneYou can now register to receive information by text message on your phone regarding appointments and health care. 

If you wish to register for this messaging service please fill out the consent form.




Alcohol Intake Questionnaire

Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.

Alcohol Consumption Questionnaire



Asthma Questionnaire - For patients who are due an annual asthma review.

Please would you answer the questions on the form below and submit it to us.

If your symptoms are deteriorating or you have any concerns, please make an appointment to the respiratory nurse or a doctor as well.

Open the Asthma Annual Review Form


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