Pennygate Medical Centre

01942 807500

Online Medical Questionnaire

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this form too (please scroll down to complete the form online), which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

If you would like to register for online services and email correspondence, please collect forms from the surgery. N.B. We cannot accept these forms without a signature and photographic ID in order to comply with patient confidentiality.