Health Reviews & Questionnaires

Quote / Testimonial:
Here we can help you monitor your condition.

Alcohol Consumption Review

If you have been invited to submit an alcohol consumption review, please complete this form.

Blood Pressure Review

If you have been advised by the surgery to submit your blood pressure readings on a regular basis, please use this form.

Contraceptive Pill Review

If you have been advised by the surgery to submit a contraceptive pill review please use this form.

Epilepsy Review

If you have been advised by the surgery to submit an epilepsy review, please use this form.

Hypothyroid Self Assessment

For many people with an underactive thyroid (hypothyroidism), taking thyroxine medication is a simple process of taking a standard and stable dose of pills every day for life. Providing you are well and stable we may be able to monitor your health without you visiting the practice.

If this applies to you (and you are not on any other tablets requiring monitoring) then before your medication runs out, please complete this assessment and we will review whether we can repeat your medication for another 9-12 months.

Male Urinary Tract (IPSS)

If you have been advised by the surgery to submit Male Urinary Tract (IPSS) review, please use this form.

Oxford Knee Score

The Oxford Knee Score is designed to assess function and pain in your knee. Please complete this self-assessment. You will have the option to send your results to your GP at the end.

Smoking Review

If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.

Asthma Review

If you have been advised by the surgery to submit an annual review of your asthma symptoms, please use this form.

Breathlessness Review

If you have been advised by the surgery to submit breathlessness reviews on a regular basis, please use this form.

COPD Assessment

If you have been advised by the surgery to submit a COPD assessment please use this form.

Epworth Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired?

This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you.

Use this scale to assess your sleepiness.

Long Term Condition Synchronisation

If you have several long term conditions we can synchronise your review appointments so that you make a minimum number of visits to the surgery. Please fill in this form to request your synchronisation.

Oxford Hip Score

The Oxford Hip Score is designed to assess function and pain in your hip. Please complete this self-assessment. You will have the option to send your results to your GP at the end.

Patient Health Questionnaire (PHQ-9)

If you have been advised by the surgery to submit a PHQ-9 form, please use this form.