Request A Flu Appointment 

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All questions marked with a * are mandatory

Personal Details
I have been invited for my flu vaccine by the surgery and meet the following criteria: Over 65, a carer, pregnant or under 65 with an underlying health condition: *

If you think you are eligible from the criteria below, please continue to complete the form. If you have any questions then please contact the surgery

*Underlying Health Conditions May Include: 

  • respiratory diseases
  • heart disease
  • chronic kidney disease
  • chronic liver disease
  • neurological disease such as Parkinson’s
  • Learning disability
  • Severe mental illness
  • Diabetes
  • Epilepsy
  • Immunosuppressed
  • Dysfunction of the spleen
  • Morbid obesity (BMI 40 or above for patients over 16)
Request an Appointment

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