EOY Statements | Griffith Avenue Practice

End of Year Statement

Patients over the age of 18 must submit their own request for statements directly and cannot be included on another request.

If you are requesting statements for dependants under the age of 18, these may be included on this form.

Please allow up to 5 working days for your request to be processed and for a response to be provided.

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Dependants Name & Date of Birth (if any)

Phone

Full Address

What year are you requesting:

2023

2024

2025

2026

I consent to this message being sent electronically to the practice. I have checked that the email address and phone number supplied are correct and consent to receiving medical information via email or text.

By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.

End of Year Statement

Contact

Opening Hours

Links

For Life Threatening Emergencies - Call 999 or 112