Parents/carers with CHILDREN 0-6 months see new guide 'Common childhood illnesses & wellbeing on ADVICE page + SEE NEWSLETTER for flu clinic info' + SOUTHBOROUGH HUB - building underway: see HUB page.

Forms for Patients

Useful forms for you to access and download by clicking title. 

1. ADULT Patient Registration form
To be completed by patients wanting to register at SAMC.

1.1 CHILD UNDER 16 Registration form
To be completed for patients under 16 wanting to register at SAMC.

1.2
CARE HOME Patient Registration form
To be completed for patients residing in care homes.


2. Travel Clinic form
To be completed by patients needing vaccinations.

8. Feedback form
To be completed by patients wanting to send us feedback on our services. (A formal complaint formal is available - see below)

17. Asthma Annual Review
To be completed by patients prior to attending their annual review.
To be complated by patients requesting access to their medical records.


19. Application for access to Health Records - Subject Access Request (SAR)
To be complated by patients requesting access to their medical records.

23. Patient online access for prescriptions & appointments form
To be completed by patients wanting to use StAMC online & other services.

28. Existing patients access to online medical records
To be completed by patients wanting to access summary medical records online

31. Complaint procedure and form
Can be completed by a patient wishing to raise a formal complaint.

33. Urine sample form
To be completed by patients leaving a urine sample for testing.

 

 

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