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.
Any responses we send will go to this email address.

Smoking Review

What is your smoking status?
How many cigarettes do/did you smoke in a day?

If you are a current smoker we strongly advise you to stop smoking. The practice runs a Smoking Cessation Clinic offering support and advice. An appointment can be made by contacting the surgery on 01926 859955

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Please ask at reception for more information about giving up smoking.

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