THYROID REVIEW

Please follow the instructions at this link to measure your heart rate

We can only accept height in cm and weight in kg. Please click here for a converter.

I understand this form is not for Urgent Care. I am happy for Chartfield to contact me as appropriate and for this information to be entered into my medical record. I am submitting this information for myself or as the authorised proxy of someone else.

Please complete all fields to submit

CHARTFIELD SURGERY

DO NOT ATTEND THE SURGERY UNLESS INSTRUCTED BY A CLINICIAN. FACE COVERINGS ARE MANDATORY.

PATIENT INFORMATION: PLEASE BE WARY OF COVID-19 VACCINATION SCAMS

THYROID REVIEW