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Important - Please note the surgery will be closed for Primary Care Forum/PLT on Tuesday 10th March from 1pm – 6.30pm – If you require medical attention during this time, please contact 111

Gladstone Medical Centre

241-247 Old Chester Road, Rock Ferry, Wirral, CH42 3TD

Telephone: 0151 645 2306

cmicb-wi.gladstonemc@nhs.net

We're open

New patient health questionnaire

Please complete this form once you have successfully registered to join the surgery. This is a questionnaire for our newly-registered patients so we can quickly update your records whilst we wait for your previous surgery to transfer your medical records to us.

  • This field is for validation purposes and should be left unchanged.
  • MM slash DD slash YYYY
  • Please enter parent/guardian name and relationship

  • Next of Kin

  • Alcohol Usage

    Scoring: a total of 5+ indicates hazardous or harmful drinking

  • Family History

  • Medical History

  • To be completed by females only

Opening Times

  • Monday08:00am to 06:30pm
  • Tuesday08:00am to 06:30pm
  • Wednesday08:00am to 06:30pm
  • Thursday08:00am to 06:30pm
  • Friday08:00am to 06:30pm
  • SaturdayCLOSED
  • SundayCLOSED

Useful Links

NHS Health A-Z

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NHS Live Well

NHS Find Local Services

NHS Mental Health
For anyone who needs some support right now...

NHS Screening

NHS 111
Calculate your Heart Age
Check your Blood Pressure Reading
SurgeryWeb

You and Your General Practice

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