Hypertension Annual Review Patient Questionnaire

…what problems you are having: * Smoking Smoking status * Smoker Never smoked Ex-smoker How many per day do you smoke? * When did you give up smoking? * Do…

Alcohol Consumption Review

…if female, or 8 or more if male, on a single occasion in the last year? * Never Less than monthly Monthly Weekly Daily or almost daily View your score…

Cardiovascular Disease Annual Review

…chest pains or angina? * Yes No Do you ever get chest pains/ angina when you are at rest? * Yes No If you are getting chest pains/angina at rest,…

Oxford Hip Score

…days Some days Most days Every day Have you been limping when walking because of your hip? * Rarely/Never Sometimes or just at first Often, not just at first Most…

Oxford Knee Score

…Some nights Most nights Every night How much has pain from your knee interfered with your usual work? (including housework) * Not at all A little bit Moderately Greatly Totally…

Doctors Schedule

Wednesday – All day Dr Sarah Tombs: Tuesday – All day Wednesday – Morning only Friday – All day Dr Rada Abdo: Monday – All day Wednesday – All day…

Prescription Medicines Order Line (MOL)

0260, 08:00 – 16:00 Monday to Friday (excluding bank holidays). If you wish to request a call back from the Medicines Order Line (MOL), please email dicb.southmolonlinerequests@nhs.net and include the…

Epworth Sleepiness Scale

…Slight chance of dozing Moderate chance of dozing High chance of dozing Watching TV: * Would never doze Slight chance of dozing Moderate chance of dozing High chance of dozing…

Blood Pressure Review

…are human, leave this field blank. Smoking status Smoker Never smoked Ex-smoker How many per day do you smoke? When did you give up smoking? Your Blood Pressure Please provide…