NHS Health Check
The NHS Health Check is a free check-up of your overall health. It is designed to identify your risk of developing certain health problems, eg heart disease, diabetes, kidney disease, stroke.

We are using this secure online system to ask you some important questions in advance.

OPTIONAL: You can submit a recent weight, height and blood pressure readings.

If you would like to, please measure your blood pressure in the morning and in the evening, while sitting down. Each time take two readings, 1 minute apart. Continue measurements twice daily for at least 4 days and ideally 7. Gathering all your readings first and entering them here will allow calculation of your average blood pressure.

SAFETY: Readings above 180/110 cannot be entered and should be reported by calling the practice.

Your answers will be attached to your medical record but may not be seen immediately. This system should never be used if you are in need of urgent medical attention. In this event, please contact the appropriate services (999 or 111) or the practice as normal.
Sign in to Google to save your progress. Learn more
If text is too small on your device, turn it sideways. You can also type the link you received into a tablet or computer browser to view on a larger screen
Practice Name - OFFICE USE ONLY *
This review is only for patients registered at the practice below. Please do not alter
Data Processing Notice
To participate in this online review you must confirm the following by ticking each box. If you are unable to do so please contact the practice
First name *
Surname *
Month of birth *
Day of birth *
Year of birth *
Ethnicity *
We ask this because some ethic groups are at higher risk of certain medical problems. Options are taken from the most recent UK census.
How would you like to enter your weight? *
If you don't want to enter your weight now this can be measured later
Captionless Image
Clear form
Never submit passwords through Google Forms.
This form was created inside of MedLink Solutions Ltd. Report Abuse