Patient Forms/Leaflets

Midwife Booking Form

UHL Midwife Booking form


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

Contraception - Pill check pre screening form


Podiatry Assessment Application

Road Traffic Accident Statement

Road Traffic Policy

Ear Wax Patient Information Leaflet

Ear Wax Leaflet

Wart & Verruca Leaflet

Wart & Verruca Leafle

Chronic Kidney Disease 

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.

NHS Choices Website - Falls

Advice on Falls & How to prevent them

Safe + Well

First Contact Plus - Falls

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