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Get help for any health problem

Get help for any health problem (COVID-19)
Required fields are labelled

COVID-19 Screening

Do you have either:

a high temperature – This means you feel hot to touch on your chest or back (you do not need to measure your temperature)
a new, continuous cough – This means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal
Who are you completing this form for?
For example, on behalf of a child or dependent
What is your name?
What is your date of birth?
For example, 31 3 1980
What is your sex?
As recorded on your medical record
The one used to register with your GP
Anyone else with access to your email account may see responses sent to you

About the Patient’s Problem

If you’re not sure, it’s helpful to tell us whether it’s been days, weeks, months or years.

BSL Interpreter

Does the patient require a BSL interpreter present at the appointment?
Video Consultation

Video consultations require you to have a smartphone, tablet, laptop or any computer with camera and microphone or headset. You will also require access to the internet, preferably over WiFi. If the practice decides on a video consultation you will be sent an email containing a link for the video consultation, so it’s best if you can receive your emails on that same device.

The practice can send a text message to your phone with your appointment time. Required
Terms & Conditions Required
If you think it would be helpful, please upload photo(s) of your condition.

Do not upload sensitive photographs of genitalia, bottoms (anus), breasts or minors without asking a healthcare professional first. Your uploads may be stored on your health record.