Severe mental illness – health check questionnaire

Use this service to submit a severe mental illness health check questionnaire.

You can use this service if you:

  • are registered at the surgery
  • have been invited to do so

This form is for people with schizophrenia, bipolar affective disorder and other psychotic illnesses. People with severe mental illness are at greater risk of physical poor health. This health check questionnaire is to support you in looking after your physical health.

Answering the questions will help us to help you to stay well. Please answer the questions as honestly and truthfully as you can.

Before you start

Call 999 or go to A&E now if:

  • someone’s life is at risk – for example they have seriously injured themselves or taken an overdose
  • you do not feel you can keep yourself or someone else safe

A mental health emergency should be taken as seriously as a physical one. You will not be wasting anyone’s time.

Call: 999

Find your nearest A&E

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
Start now

You can also phone us on Millwood Surgery 01493 444484 or Falkland Surgery 01493 442233