Learning Difficulties Priority Access Form

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The practice has given careful consideration on how we can assist patients with Learning Difficulties who require contact with a clinician.

We would like to offer access to a priority email account, only for patients on our Learning Difficulties register. Please note anyone using this email account to contact the practice other than these patients or their carers will have their email deleted, it will not be processed.

This priority access is for the patients only and is not extended to carers or family members. However, if there is an urgent concern, please call the surgery directly.

Before we can release details of this priority email account, we must update and correct our records. Please complete the following online form.

We will then email back to the email address you supplied, the details of the priority email account and how to contact the practice.

 

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All questions marked with a * are mandatory

Personal Details
Please double check you've entered the correct email address
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Priority Carer Details
Does carer live at the same address as patient?: *
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Privacy Consent

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