Request a routine GP appointment

Pharmacy First

About the Patient’s Problem

Please tell us about the problem and your symptoms, providing as much information as you can. If the practice is already aware of this problem, please tell us what has changed.

How long has this been a problem?

If you’re not sure, it’s helpful to tell us whether it’s been days, weeks, months or years.

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)

How would you like us to deal with the problem?

Telephone

Face to face appointment

Is there a member of staff who would be best to deal with this problem?

The practice can send a text message to your phone with your appointment time.

I agree to the practice sending me text messages including appointment times

I do not agree to the practice sending me a text message with my appointment time

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.

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Confirmation

I confirm my query is not urgent, and I understand it might not be looked at until the next working day.

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Request a routine GP appointment

Pharmacy First

About the Patient’s Problem