Referral Request

As your referral was not list under self-referrals, then please note you may use this form to make an inquiry about a referral.

We will not necessarily action any referral from your inquiry in this form and will ask you to make a routine appointment to see a doctor at the surgery to discuss the clinical necessity of your referral request.

All our referrals are vetted by the hospital/secondary care providers and are rejected if a patient’s problem/condition is in fact meant to be managed in primary care by the GP surgery!

Thank you

Referral Request

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.