About This Form
By sending this form you are not booking an appointment or telephone consultation.
You are requesting that a routine appointment or telephone call be booked for you.
This is why you cannot specify an exact time and date. Should you feel that you
have an urgent medical problem, please contact the surgery directly by telephone,
rather than using this form.
When an appointment or call has been booked for you, an email will be sent with
the details. You must ensure that you do not have a spam-blocker installed or any
other kind of software that will reject this automatic email.
If, for some reason, you are unable to keep the appointment or accept the call please
phone the surgery and cancel as soon as possible.
Please Note
By using this form you will be sending information about yourself across the Internet.
Whilst every effort is made to keep this information secure, you should be aware
that we cannot offer any guarantees of absolute privacy. If this matter concerns
you then you should call the surgery to request an appointment.
Personal Information
Personal information retained on this system is stored in a secure data centre located
in the UK and is treated as confidential.