information you would like to inform us of? DETAILS OF THE PERSON YOU CARE FOR: NAME ADDRESS (if different from above) POST CODE TEL NO DATE OF BIRTH RELATIONSHIP TO YOU Are they registered at The Old Dispensary? Would you like to be contacted by our Lead’? YES / NO ‘Carers SURGERY USE: SCAN and CODE 918G Nov 2017 The Old Dispensary Patient Access – Patient Access mobile app Free on Android and iOS With Patient Access you can now access your local GP service at home, work or on the move wherever you can connect to the internet. What’s more, because Patient Access is a 24 – hour online service you can do this in your own time, night or day. Book a GP appointment repeat prescriptions Change your personal details View certain aspects of your medical record For further details please visit If you would be interested in signing up for this service please complete your details below: NAME ADDRESS
information you would like to inform us of? DETAILS OF THE PERSON YOU CARE FOR: NAME ADDRESS (if different from above) POST CODE TEL NO DATE OF BIRTH RELATIONSHIP TO YOU Are they registered at The Old Dispensary? Would you like to be contacted by our ‘Carers Lead’? YES / NO SURGERY USE: SCAN and CODE 918G Nov 2017 The Old Dispensary – Patient Access Patient Access mobile app Free on Android and iOS With Patient Access you can now access your local GP service at home, work or on the move – wherever you can connect to the internet. What’s more, because Patient Access is a 24 hour online service you can do this in your own time, night or day. Book a GP appointment repeat prescriptions Change your personal details View certain aspects of your medical record For further details please visit If you would be interested in signing up for this service please complete your details below: NAME ADDRESS
NEW%20PATIENT%20QUESTIONNAIRE%20NOV%2017.docx