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Have you ever received treatment within a substance misuse treatment programme please circle YES NO If Yes please list overleaf any medications or treatment you are currently or have recently been prescribed as part of a substance misuse programme either with your current/most recent GP or other treatment provider such as The Drug Intervention Programme Addaction The Junction HMP or other provider. Birkwood Surgery APPLICATION TO JOIN PRACTICE Date of request Occupation Surname Address...
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Step 1: Obtain the Birkwood Surgery form from the reception desk or download it from their official website.
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Step 3: Fill out your personal details accurately, including your full name, address, contact number, and date of birth.
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Step 4: Provide your medical history, including any chronic illnesses, allergies, or previous surgeries.
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Step 9: Submit the filled-out form to the receptionist at Birkwood Surgery or follow their specific instructions for online submission.
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Birkwood surgery is a medical procedure or treatment that involves the surgical intervention.
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