Patient Health Questionnaire

GP Practices are now required to record ethnicity information on all patients registered at the practice. If we do not have ethnicity information recorded on your record you would have recieved a text from us to ask you to fill in the form below.

The information you provide us with will be used lawfully, in accordance with the Data Protection Act 1998.

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Practice Health Questionnaire

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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