Get help for any health problem

Use this form at any time to get help from your practice. We aim to respond within 2 working days.

Get help for any health problem (COVID-19)

COVID-19 Screening

Do you have either:

a high temperature - This means you feel hot to touch on your chest or back (you do not need to measure your temperature) *
a new, continuous cough - This means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual) *
loss or change to your sense of smell or taste - this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal *
Have you been told by 111 to contact the practice? *
Do you live with someone who has had a high temperature or a new, continuous cough? If their symptoms started more than 14 days ago, click No. *
Please continue to fill out this form
Your symptoms suggest you might have Coronavirus (COVID-19). You should use the 111 online coronavirus service to find out what to do.

Are you happy for us to make sure this number is updated in your medical record?
Have you, or the person you are requesting for, been advised to shield yourself because of your health? *
Have you, or the person you are requesting for, left your house since the end of March or since received advice to shield?
Have you or the person you are requesting for, had anybody visit you in your home?
Are other members of your household socially distancing from you?

About the Patient's Problem

If you're not sure, it's helpful to tell us whether it's been days, weeks, months or years.
If your problem is to do with joints and muscles, we may refer you to the First Contact Practitioner physiotherapy service. Please specify if you are happy for us to do so:
How would you like us to deal with the problem? *
Please bear in mind that we may not be able to deal with your problem in your preferred manner.

Online message sent through your email

Telephone

Face to face appointment

Video Consultation:

Video consultations require you to have a smartphone, tablet, laptop or any computer with camera and microphone or headset. You will also require access to the internet, preferably over WiFi. If the practice decides on a video consultation you will be sent an email containing a link for the video consultation, so it's best if you can receive your emails on that same device.

Please view our full staff list.
How quickly do you think the problem needs to be dealt with? *
The practice can send a text message to your phone with your appointment time. *
Terms & Conditions - Please select both boxes before submitting *
If you think it would be helpful, please upload photo(s) of your condition. If you have a rash, acne, or anything that needs to be viewed by the clinician, please upload images of the issue.
Drop a file here or click to upload Choose File
Maximum upload size: 20.97MB