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1. |
Please fill in all
the grey boxes. |
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2. |
Use the TAB button on your keyboard, or use
your mouse to the next box. Please do NOT hit Enter
on your keyboard. If you do this, you will be told
you have not filled in the form correctly and asked
to do it again. |
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3. |
We aim to reply to messages ASAP but we CAN NOT
give a timescale. |
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4. |
Please DO NOT
ask for URGENT MEDICAL
ADVICE using this form. If you are in
ANY DOUBT as to
whether your query is urgent, please telephone us.
If you are telephoning 'out of hours' you will be
put through to the local 24 hour service. Grosvenor
Road Surgery WILL NOT
be held at all responsible for
ANYONE using this
form to contact their doctor. |
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5. |
You must accept the Terms & Conditions of this
service by ticking the checkbox at the bottom of the
form. You will not be able to use this form without
accepting the Terms & Conditions of Service |