We invite you to answer a few questions in order to ensure that you are happy to proceed. If all of your answers indicate that you are happy to proceed, we will refer you for the procedure.
You can use this service if you:
- are registered at the surgery
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
You can also phone us on 01543 416633.