Welfare Advice Advisor

We now have a Welfare Advice Advisor as part of our staff team, they can offer a range of support for someone with money worries. They provide a person-centred approach

Fernbank Medical Centre > Forms > Keep us up to Date > Test Results Request Form

Test Results Request Form

Please complete this form to request your test results. A member of the Practice Team will call you within 2 working days. Alternatively you may call the practice between 9 and 12 noon and leave a number for someone to call back.

Request Test Results

First Name *

Last Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Type of Test

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

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