Patient Forms

You can now download the forms listed below at your own convenience.

  • New Patient Form (GSM1) – click here
  • Summary Care OPT OUT Form – click here
  • Summary Care OPT OUT Form – click here
  • Blood Donor – to register click here
  • Patient Complaint Form with 3rd Party Consent – click here
  • Text Messaging OPT IN – please complete the form below
    OPT IN for text messaging
    First
    Last
    Address *
    Address
    City
    County
    Postcode
    (The number provided will be used by Peel Hall Medical Practice to contact you via text messaging)
    Please always ensure that you keep us informed if you ever change your mobile number for this service.
    Sorry this service currently only available to patients who are 16 years old or above.

IMPORTANT NOTICE : Coronavirus (COVID-19) If you have arrived back from or recently travelled to any of the affected areas and have symptoms of a cough, runny nose, sore throat, fever, or difficulty breathing please self-isolate immediately and call NHS 111 and you will be guided on how to proceed. --------------PLEASE NOTE WE ARE NOT ISSUING 'FIT TO TRAVEL/FLY OR FACE MASK EXEMPTION LETTERS'--------------
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