Request an appointment with a Nurse or Healthcare Assistant

Tell us when you want your appointment and we will reply to you with a time. Once we receive this form we will process it within 2 working hours.

Request an appointment with a Nurse or Healthcare Assistant (COVID-19)

COVID-19 Screening

Has someone who has tested positive (i.e. a confirmed case) of coronavirus been in close contact with you? *
Close contact with a confirmed case means:
  • living in the same house with someone who is self-isolating on NHS 111 advice
  • face-to-face contact, for example, talking for more than a few minutes
  • being coughed on
  • being within 2 metres of the person for more than 15 minutes
  • contact with their body fluids
Do you have any of the following:

Section

The practice can send a text message to your phone with your appointment time. *
Appointment required (tick all that apply): *

Blood tests must be taken before 13:00.

You can also book blood tests directly using the NHS App or Patient Access.

Cervical screening:

If you would like to request an appointment with a Nurse Practitioner, please complete the Get help for any health problem form instead.

Have you been told when to have the appointment, for example, "in the next two weeks" or "in one month's time"? *
*