This form should be used for SAME DAY (urgent) appointment requests only.

If your medical issue is not urgent, you can book an appointment up to two weeks in advance. Please call the surgery to book a routine appointment.

How Do I Make An Appointment

Check it's not an emergency.

Call 111 or 999 for urgent medical help if you have any of these as your request will not be seen immediately.

  • Crushing chest pain and tightness
  • New drooping on one side of the face, slurred speech, difficulty raising your arms, weakness or numbness on one side of your body.
  • Severe difficulty breathing
  • Heavy bleeding that won't stop
  • Severe injuries
  • Feeling suicidal, wanting to harm yourself, or other.
For sever mental health issues please contact NHS 111 and select option 2 to speak to a Mental Health & Wellbeing Practitioner.

If you use this form for Routine Appointment Request, Medication or Sick Note requests, the form will not be accepted and WILL NOT be processed.

Is this request submitted for yourself or for someone you care for? - Please note the practice must have received written consent to discuss any patients’ medical needs who are over the age of 18+

We require all the following questions to be completed to allow us to process your request.

Please be aware that we are seeing patients face-to-face and you may be asked to attend the surgery. We ask that you are available during the day that you request your same day appointment.