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New Patient Health Questionnaire for Adults

When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

1Your Contact Details

Please provide an email address where possible

2Information About You


Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


Your Neighbourhood Professionals. Just a Click Away!
Sleaford Road Medical Centre, Sleaford Road, Boston, PE21 8EG
Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals. Just a Click Away!
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