GP Solutions Group

Ballochmyle Medical Group eConsult

Please note Submitted forms are only viewed and processed during normal GP working hours. Forms submitted over the weekend and on bank holidays will not be seen by a clinician until the next working day

Please DO NOT complete this form if you have any of the symptoms below. Please phone 999.

  • Possibly heart attack/stroke
  • Severe chest pains
  • Severe breathing difficulties
  • Severe allergic reactionor anaphylaxis
  • Fitting
  • Drowsiness, confusion or unconsciousness
  • Severe burns or scalds
  • Suffered trauma or a head injury
Please tick to confirm you do not have any of the symptoms listed above*

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

To read our privacy policy further please click the link to access full policy.

Ballochmyle Medical Group Privacy Policy

Please tick to confirm*
Please tick if completing this section on behalf of a patient under 16 years of age.
Name*
DD slash MM slash YYYY
Address*
Please select which service you require today.*

GP/ANP Consult

If your request is regarding a visible issue i.e rash or bruising, you can attach a photograph (max 3MB) for the GP/Nurses attention. Ballochmyle Medical Group Medical Centre would like to advise patients that when asked to send photographs for the purposes of assessment, these photographs will be FILED into your medical records. Please DO NOT send any images of private sensitive areas of the body.

Drop files here or
Max. file size: 3 MB, Max. files: 5.

    Nursing Consult

    If your request is regarding a visible issue i.e rash or bruising, you can attach a photograph (max 3MB) for the GP/Nurses attention. Ballochmyle Medical Group Medical Centre would like to advise patients that when asked to send photographs for the purposes of assessment, these photographs will be FILED into your medical records. Please DO NOT send any images of private sensitive areas of the body.

    Drop files here or
    Max. file size: 3 MB, Max. files: 5.

      Admin Query

      Pharmacy Query

      Request for Fitnote

      Please note we are unable to email sicklines at present.
      We advise that you or a representative can collect sicklines from the practice.
      DD slash MM slash YYYY
      DD slash MM slash YYYY

      Other

      Consent

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

      Copyright © GP Solutions 2021.