The following are links to commonly requested forms available for download:
REGISTRATION
- Registration Form– Please complete and bring to reception with proof of address, Photo ID and the New Patient Questionnaire below
- Practice leaflet
- Please complete the new patient information and questionnaire form and bring to reception. Adults Aged 16+ and Children (0-15) one form per person.
- Change of Details Form – If any of your contact details have changed please complete the form and drop it off at the surgery or email it to mseicb-me.hedinghamlistens@nhs.net
- Carer Registration Form
- Proxy Online Access Form Birth to 13 years Please complete this form and return it to the surgery
- Proxy Online Access Reg Form 13 yrs and over. Please complete this form and drop it off at the surgery in person so that the teenager can sign the consent form at reception.
SERVICES
- If we ask you to fill in a Glucose Diary as part of your diabetes care, you can download it here: Glucose Diary
- Non-NHS Fees Price list. See the SERVICES section for more information. NON-NHS FEES 2023-2024
- If we ask you to complete and submit an Anxiety and Depression Questionnaire you can download it here: Anxiety Depression Questionnaire
- Self Certification Sick Note for less than 7 days. If you have been ill for 7 days or less you don’t need to see a Doctor. You can complete a Self Certification form yourself. Many employers have their own self-certification forms. For more information visit the Gov.UK website. However some employers insist on a Doctor’s note regardless. A Doctors note under these circumstances involves a charge of £20.
- If we ask you to read and sign a Patient Agreement to IUS Insertion, you can download it here; Patient Agreement to IUS insertion
INFORMATION
- The Practice Privacy Notice is here Fair Processing Notice 2023
- Subject Access Request Form – If you would like a copy of some or all of your medical records, use this form to make a request. We will aim to let you have copies within 30 days
- Practice leaflet
- Interpreter request form – if you need an interpreter please download this form and and drop it off at the surgery or email it to admin.hedmed@nhs.net
- Online services- The NHS APP will allow access to request repeat prescriptions online and to view parts of your medical record. (Appointments is currently disabled due to Covid-19).
- If you have connection issues with the NHS App then read this guide – it will help you get connected NHS APP Help Guide
- Consent to Share Information Form If you would like to give us permission to discuss some or all aspects of your care with a family member, friend or carer, please download and fill in one of our Consent To Share Information Forms and return it to reception at either Sible Hedingham or Castle Hedingham.
- Vitamin D Read our information leaflet about Vitamin D by clicking this link: Vitamin D patient information leaflet
