Medical History

Step 1 of 9

We need to ask patients about their general health so that we can treat them safely. Please write the PATIENT’S details below and then answer the health questions about the PATIENT. All information will be kept confidential.

Patient details

Patient number (Patient Clinical Number) consists of 5 digits and can be found on any emails or letters we have sent to you. Incorrect numbers entered will result in our system automatically rejecting your submission. If you don't know your Patient number, please contact us at reception@orthwise.co.uk. Any submitted forms and appointment bookings will be rejected without this number.
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