Lincoln House Surgery

Lincoln House Surgery

163 London Road, Apsley, Hemel Hempstead, HP3 9SQ

Current time is 05:11 - Sorry, we're currently closed. Please call NHS 111

NHS

Telephone: 01442 254 366

When the practice is closed please dial 111 For emergencies dial 999

Breaking News: FLU CLINICS update: Limited appointments left for Saturday 25th September. More appointments added mid-week but they are filling fast. Book ASAP to avoid disappointment. Click on the LINCOLN HOUSE SURGERY 2021 section on the blue banner (or menu if you are on a mobile device) for more information.

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Referral Request

You are here:
Home
/
Referral Request

Referral Request

If you would like a referral please fill the form and one of our doctors will be in contact with you in due course.

Referral Request

"*" indicates required fields

Name*

Prefix First Last

Date of Birth*

Phone

Email

Named GP if known

Who would you like a referral to?*

Why do you need this referral? Please give as much details as possible.*

Comments

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

FLU BOOKINGS via online access - i.e Patient Access - for eligible patients

Order your Prescriptions

Update your details

News

Patient Participation Group

Medication reviews

Admin Requests

Contraceptive Requests

Med3 Fit Notes (Sick Notes)

Can't find your health condition? REQUEST GENERAL ADVICE

Cancel an Appointment

Opening Times

Monday
08:00 until 18:30
Doors open at 08:30am
Tuesday
08:00 until 18:30
Doors open at 08:30am
Wednesday
08:00 until 18:30
Doors open at 08:30am
Thursday
08:00 until 18:30
Doors open at 08:30am
Friday
08:00 until 18:30
Doors open at 08:30am
Saturday
CLOSED
Sunday
CLOSED

Useful Links

NHS Choices

NHS 111

Patient UK

Everyone is welcome

Order your Prescriptions

If you have access to Patient Access and you usually order your prescriptions there, you can still do so by accessing your Patient Access account

You can access it from the information tab under Patient Access, from the Forms tab under prescriptions or on the main homepage at the very bottom by clicking on the Patient Access logo. https://www.patientaccess.com/ If you do not have Patient Access, please fill the below form.

Name*

First Last

Date of Birth*

Telephone*

If there are any problems with issuing your prescription, we may call you to let you know.

Email

Medications required*

Drug

Strength

Quantity

Please note, prescriptions will be available in 2 working days excluding weekends and bank holidays.

Comments

Consent*

I have nominated a pharmacy and will arrange my collection from the pharmacy.

Privacy*

By using this form you agree with the storage and handling of your data by this website. *

Email

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

Update your details

Present Name*

Prefix First Middle Last

Date of Birth*

Please select the information you are wanting to update:

Name

Address

Contact numbers

Other

Consent

I understand that in order to update my name I will have to show proof ID, either marriage certificate, birth certificate or deed certificate showing the new name. NO NAME CHANGES WILL BE DONE UNTIL DOCUMENTS HAVE BEEN SEEN BY THE SURGERY

File

Max. file size: 2 MB.

Proof of ID (If needed only as above)

Previous Name

Prefix First Middle Last

Home number (telephone)

Mobile*

Email*

New address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous address

Please list all family members moving with you:

Consent*

I agree to be contacted by text message by the surgery

CAPTCHA

Privacy*

By using this form you agree with the storage and handling of your data by this website. *

Comments

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

Cancel an Appointment

Name(Required)

Prefix First Last

Date of Birth(Required)

Phone(Required)

Email

Appointment date(Required)

Who was the appointment with?(Required)

Do you need to re-schedule your appointment?(Required)

YES

NO

If you need to re-schedule please let us know when it would be most suitable. (i.e. in mornings, afternoons, etc. ) We will try our best to accommodate your request depending on appointment availability.

Comments

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

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