Skip to content
Call
0800 0614734 01753 373646
Email
healthier.slough@nhs.net
Home
About
Services
Health Professionals
Referral
Contact us
Home
About
Services
Health Professionals
Referral
Contact us
Contact us
Referral Form
I would like to
Schedule a call
Book an appointment
Make a professional referral (secure)
Contact you about something else
Choose Service
Stop Smoking
Weight Management
Falls prevention
NHS Health Check
General Assessment
Youth Vaping Cessation
Client name
GP details
Is the client pregnant?
Yes
No
Address
Email address
Telephone number (preferred)
Telephone number (alternative)
Notes or comments
Have you been referred as part of the Lung Health Check programme?
Yes
No
This is a secure form. The details you provide will be sent to our secure nhs.net Email Address
Consent
Consent provided
Submit
