Get help for any health problem

The Government plans to offer the flu vaccination to all 50-64 year olds from 1st December. We do not have the vaccinations to offer this currently, so please do not contact us about this yet.

Use this form at any time to get help from your practice. We aim to respond within 6 working hours.

This form is for one problem only, please complete one form for each problem.

Please be aware that requests received after 4:30pm may not be reviewed until the next working day.

If you are human, leave this field blank.

Section

About the Patient's Problem

Please tell us about the problem. If the practice is already aware of this problem, please tell us what has changed. *

Do you have any ideas about what is causing the problem? (Optional)

What are the concerns? (Optional)

How would you like us to help? (Optional)

Our clinicians will decide whether an appointment is the best way to help you. We might need to send you a secure online message, phone you or arrange a video appointment.

Are there any days or times within the next few days when you would not be free for a telephone call or appointment?

Terms & Conditions *

I confirm that this problem is not an emergency. I understand that the practice will not deal with this problem while the practice is closed.

If the problem worsens and may require immediate help, I will visit NHS 111 Online or call 111. In an emergency I will call 999.

If you think it would be helpful, please upload photo(s) of your condition.

Maximum upload size: 67.11MB

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