Important - Please note the surgery will be closed for PLT training on Tuesday 30th April from 1pm – 4pm – 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

Sorry, we're currently closed. Please call NHS 111

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.

  • 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

  • This field is for validation purposes and should be left unchanged.

Opening Times

  • Monday
    08:00am to 06:30pm
  • Tuesday
    08:00am to 06:30pm
  • Wednesday
    08:00am to 06:30pm
  • Thursday
    08:00am to 06:30pm
  • Friday
    08:00am to 06:30pm
  • Saturday
  • Sunday