If you are due for your yearly asthma review, or would like to update are records about your asthma, review it would be very helpful to complete this form about your asthma. You can use it to request a review of your asthma, or for advice about smoking, but if you are having significant problems with your asthma then please phone the practice in the usual way to make an appointment.
Please note that you will be sending this information over a standard internet connection. If you are concerned about security of your information then you can use your 5 digit Binscombe code so that you cannot be identified outside of the practice (this code is on your repeat prescription page, or we can advise you of it if you contact the surgery). Alternatively you could print out the completed form and deliver it to us.