CHARTFIELD SURGERY

020 8788 3252 - Dial 111 Out of Hours

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

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.

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