Smoking Review

If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.

Smoking Review

Smoking Review

About You

Please use this date format: DD/MM/YYYY.
Remember to look at our Wellbeing Centre for more self-help advice.

Smoking Review

Do not currently smoke section

Do currently smoke section

If you are interested in stopping smoking, please visit www.smokefreelifeberkshire.com.

Please note that the details you give will be used to update your medical records.
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