Online Consultation Request

    • Information
    • About You
    • Your Symptoms
    • Changes to Symptoms
    • Associated Conditions
    • Ideas & Concerns
    • Your Expectations

    Check it’s not an emergency

    Call 999 now if you have:

    • signs of a heart attack - pain like a very tight band, heavyweight or squeezing in the centre of your chest
    • signs of a stroke - face drooping on one side, can’t hold both arms up, difficulty speaking
    • severe difficulty breathing - gasping, not being able to get words out, choking or lips turning blue
    • heavy bleeding - that won’t stop
    • severe injuries - or deep cuts after a serious accident
    • seizure (fit) - someone is shaking or jerking because of a fit, or is unconscious (can’t be woken up)
    • sudden, rapid swelling - of the eyes, lips, mouth, throat or tongue

    I confirm that I have none of these.

    This service is only for non-emergency/non urgent cases and available to patients registered at this practice. Please note that after submitting the online consultation request, your GP Practice will assess your symptoms and will contact you with the appropriate follow-up advice within 48 working hours. If you think you need urgent attention,please phone your GP Practice directly on 0121 476 2441.

    I confirm that I am registered with this practice.

    I understand that it may take up to 48 working hours to respond.

    Tell us about you, or the person you're asking about? If the patient is under 13 years old then parents consent is required.

    What is your first name? (required)

    What is your surname? (required)

    What is your date of birth? (required)

    What is your email address? (required)

    What is your preferred contact number? (required)

    What can you tell us about your symptoms?

    Please describe your symptoms.

    How long ago did your symptoms start in days? (Enter 0 if your symptoms started today)

    What can you tell us about your symptoms?

    Does anything make your symptoms feel better?

    Does anything make your symptoms feel worse?

    What can you tell us about your symptoms?

    Are your symptoms associated with any other symptoms?

    What treatments have you tried already?

    What can you tell us about your symptoms?

    Do you have any idea what might be causing your symptoms?

    Is your symptom visible, for example a skin condition that you would like your doctor to see? If yes you may upload a good quality image here.

    Do you have any concerns about your symptoms?

    What are your expectations of this assessment?

    AppointmentPrescriptionReferralAdviceOthers

    What is your preferred day to be contacted?

    MonTueWedThuFriSatSun

    What is your preferred contact time?

    AMPMAll day

    By clicking the submit button your online consultation request will be sent to your GP Practice. We will assess your symptoms and all appointments will be on the phone within 48 working hours. Please be near the telephone provided. Face to Face appointments will be given only at the discretion of the clinician.

    We will endeavour to contact you within this time, but if you don't hear from us within 48 working hours OR if you think you need urgent attention, please call the reception.