New Road Surgery: 01923 604884 Out Of Hours: 111Patient Access
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  • Height & weight

  • Blood pressure

  • Smoking

  • Alcohol

  • 1 drink = 1/2 pint of beer or 1 glass of wine or 1 single spirits.
    1 unit of alcohol = 10cc of alcohol. So, a small glass (125cc) of 12% wine is 12.5 * 0.12 = 1.5 units.

  • Other Information

  • Please note that no medical information or questions will be responded to. The data you supply on this form will be stored on our website, which is hosted by a third party, until it has been processed by the practice. The data will be used lawfully, in accordance with the Data Protection Act 2018, which gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly. The practice privacy policy can be viewed on this website.

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