Use this service to submit your request for a non-NHS service or a medical report request.
Please ensure you complete all the questions accurately to facilitate seamless access to our online services.
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
We would request that you provide a personal and secure email address. If you share your email with anyone else, they will be able to see confidential communications from the practice. Please see our guidance on safe online access to your medical records for more information.
Start nowYou can also phone us on 020 7619 6670.