Mansion House Surgery National Health Service

Patient Health Questionnaire :

Health QuestionnaireAccess our Health Questionnaire.

In order for us to ensure your medical records are up-to-date, we would be grateful if you would take a few minutes to complete our online Questionnaire. The information requested is basic and is of course confidential.

Additionally, the Department of Health has asked all G.P practices to ascertain the smoking habits of their patients so that services and resources can be directed to those patients wishing to quit.

It is therefore important that patients completing this Questionnaire confirm whether or not they are a current smoker, a past smoker or have never smoked tobacco.

If you do not wish to complete the Questionnaire online, please contact us and we will arrange a paper copy to be sent to you.

Thank you.

Access our Health Questionnaire.













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