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My name is Debbie, I am one of the Nurse Practitioners at Carterknowle & Dore Medical Practice.
You are due an annual check-up, where we will discuss any worries you have about your health, the medicines you take and your general health.
To help with this review I have sent you some questions below; you can take your time in looking at the questions and think about your answers.
Please fill in the questions in the questionnaire below. Please do not worry if you can’t answer all the questions.
If you have someone who helps look after you, you can ask them to help answer the questions.
Once you have completed the form we will be in touch to arrange you an appointment to go through your answers and discuss any questions you are unsure about