This page gives you a breakdown of the information we collect that will likely be of most interest to your practice.
There are two parts of the form the patients complete the π±Core form and πMedical form.
π±Core form sections
π±Core form sections
Patient details
Ethnicity
Religion
Sexual orientation
First arrival into the UK
Children section (if applicable)
Lives with guardian
Has a social worker
Is Fostered
Current Address
Postcode
County
Nursing home
Contact details
Preferred contact method
Consent for non medical contact
PPG attendance
Previous details
Previous names
Has moved
Previous GP
Emergency contact
Is patient already
Lives with patient
Can discuss records
πMedical form sections
πMedical form sections
Conditions
Disabilities
Alcohol
Smoking
Exercise Frequency
Allergy
| Specific Questions |
|
Category | Questions | Coded? |
π§π½ββοΈGender and Sexuality |
| Coded |
π£ Language |
| Coded |
ππ½ Religion |
| Coded |
πΆ Child Safeguarding (only for u18) |
| Coded |
π Care home |
| Coded |
π‘Armed Forces |
| Coded |
βοΈSpecial circumstances |
| To be coded soon |
π¬π§ Living/ Moving to the UK |
| updated/ coded |
π· Long Term Illnesses
|
| Not Coded |
π Repeat medication
|
| Not Coded |
π Summary Care Record Consent* |
| Coded |
π Preferred Method of Contact |
| Coded |
β¨ Our form completion experience is consistently receiving a satisfaction rating of 4.83/5 β¨
* Patient data preferences can only be updated if they have an English NHS number. Patients will be notified of this during their registration.