Smoking Review

If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.

Smoking Review

Smoking Review

About You

Please use this date format: DD/MM/YYYY.
Responses we send will go to this email address

Smoking Review

Smoking Cessation clinics are held at the Surgery on a weekly basis with the Stop Smoking Co-ordinator - you may self-refer to this clinic, please book an appointment at Reception. Nicotine replacement and other medications are available on prescription to assist you in stopping smoking and are available once you are under the care of the stop smoking co-ordinator.

Do not currently smoke section

Do currently smoke section

Sending