Patient Forms/Leaflets


Review for women taking Oral Contraceptive Pills, form to be completed and returned to the surgery:-

Pill Check Form


Podiatry Assessment Application Form

Road Traffic Accident (RTA)

Road Traffic Accident Statement

Ear Wax Patient Information Leaflet

Ear Wax Leaflet

Warts & Verrucas Leaflet

Warts & Verrucas Leaflet

Links to useful Websites

Statutory Sick Pay (SSP) - SC2 - Self certification

For SSP purposes, an employer is not entitled to ask for a medical certificate, signed by a doctor, for the first seven days of absence from work due to incapacity. The employee is only required to notify the employer of the incapacity and provide self-certification of their incapacity, in writing.

Form SC2 is available for this use, or the employer may provide employees with their own form or accept a letter giving the information they require in order to consider SSP entitlement.

You can obtain these from the surgery, alternatively click on the link.

Preventing Falls Leaflet 2017

NHS Choices Website - Falls

NHS Choices Website - Falls

NHS Choices Website - Falls Prevention

Safe + Well

First Contact Plus - Falls

Domestic Abuse

Transgender cross programme screening leaflet

Health for Under 5's

Leicestershire Partnership Trust have now launched their new website for parents and carers - Health for Under 5s.  This is a brilliant resource for parents and carers from pregnancy through to toddler aged children. The website can be found at:

Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website