Information:
If the patient cannot fill it in then a family member, relative or carer can fill this form in for them. We no longer accept urine samples at the practice without this form being filled in either online or on a paper copy that you can pick up from the practice.
Use this service if you think you have a urine infection and a clinician will be text or call with advice by a nurse / doctor on the same day.
You can use this service if you:
- are registered at the surgery
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
You can also phone us on 0333 242 7777.