Face coverings – you are welcome to use a face covering. You do not have to.   

We would request you use a face covering if you have a cough or cold.  

Thank you. 


Decline Your Flu Jab

Please complete this form if you do not want your flu jab this year. If you change your mind, you can still have your flu jab – simply contact the surgery.

Your Details

I would like to decline my flu jab for this Autumn because: *  
I take full responsibility for declining my flu jab and the impact this could have on my health *  

How do we contact you?

Please confirm if you would be happy for the surgery to communicate with you by e-mail  
I would like to receive text reminders  
Fields marked with an asterisk (*) are mandatory