See opening times

Surgery phone

0113 467 7533

Surgery fax

0113 263 9399

Online forms

List of eConsultation forms available with and without logging in

There are two types of online forms on the website and they are processed differently.

  • All of the forms are available via the clinical software and you need to log in (you will need to register first).
    • You need to use:

    SystmOnline Access

  • Some can also be done directly without login by filling in your details and submitting via this website.The forms that are directly available on the website have links.

We encourage you to log in as it allows you not only to access all online forms but also book appointments, order prescriptions, check your tests and more.

Chronic disease review (Like Asthma, COPD, diabetes)

It includes

  • Asthma.
  • Cardiovascular disease (Heart Disease, High blood pressure, stroke)
  • COPD
  • Diabetes and Pre-diabetes
  • Epilepsy
  • Mental health

SystmOnline Access

Common Conditions (Like hay fever, snoring)

It includes:

  • Hay fever
  • Snoring

Contraception.

It includes:

  • Contraceptive pill
  • Vasectomy referral.

SystmOnline Access

General health (Like Diabetes risk, Lifestyle, health check)

It includes:

  • Diabetes risk assessment
  • Lifestyle assessment
  • New patient health check

 

SystmOnline Access

 

General queries (Like appointment cancel,Referrals, Sick note)

It includes:

SystmOnline Access

Infections (Like Athlete’s foot, BV, thrush)

It includes:

  • Athlete’s foot
  • Bacterial vaginosis
  • Urine infection
  • Vaginal Thrush

 

Miscellaneous (Like Consent, travel)

It includes:

  • Consent to share your electronic information.
  • Feedback
  • Travel

If travelling, please notice you need to provide the information 4 weeks before your trip to allow a vaccination program to take place. If not possible, please go to a travel clinic.

SystmOnline Access

 

Palliative care.

It includes:

  • Carer questionnaire
  • End of life preferences.
  • Palliative care review

 

 

SystmOnline Access

 

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