Some patients or clients may need a little extra help to access the support on offer for a healthier lifestyle.
A practitioner from our One You South Gloucestershire team is on hand to help. They will discuss your patient or client’s needs with them. Your patient/client might for example need help to read about the benefits of ‘Moving More’ from our website. On the other hand, they might want to discuss the range of options for mental health and wellbeing with the wellbeing team. For those who need more help in making a lifestyle change such as losing weight or stop smoking, we offer telephone support to take them through the change.
If you have a service for stopping smoking at your GP practice, you need to use your in house service before referring to us.
Is the referral part of a:
NHS Health CheckOther GP practice appointmentMSK HO PilotOther (please state)
For example, 01 08 1997
DateMonthYear
We use this to help link you to local services in your area
Are they registered at a South Gloucestershire GP Surgery
No
Which of the following topics are they interested in?
Tick all that apply
The information they provide enables us to check that we give a good and fair service to everyone and identify how we could potentially improve our services to them in the future.
All their answers will be treated in the strictest confidence and will only be used to monitor and help improve our services.
You can read more about our monitoring in our privacy policy.
Includes any Asian background, for example, Bangladeshi, Chinese, Indian, Pakistani
Includes any Black background
Includes any Mixed background
Includes any White background
Includes any other ethnic group
or Prefer not to say
This could be a physical or sensory impairment, mental health condition, learning disability or difficulty, long standing illness or health condition.
No or Prefer not to say
How would they prefer to be contacted about this referral?
The information you provide enables us to check that we give a good and fair service to everyone and identify how we could potentially improve our services to you in the future.
All your answers will be treated in the strictest confidence and will only be used to monitor and help improve our services.
Inclues any other ethnic group
or Full time studentIntermediateManagerial and professionalNever worked or long term unemployedRetired or Home carerRoutine and manualSick or disabled and unable to workUnable to codeUnknown
The information provided will be used to provide the service. It will only be shared with our partners involved with delivering One You South Gloucestershire, in accordance with South Gloucestershire Council's privacy notice.
Your patient or client may tell us at any time if they would like to stop the service or update their details.
Once we receive the referral, we aim to contact your patient or client within two working days. We regret we will not be able to confirm receipt of referrals.
If your patient or client is registered with a South Gloucestershire GP, we will give feedback to their practice on whether they receive support from us as a result. We will not give any details of the support provided.
Select Yes if you agree to these terms and conditions.
As your patient or client does not give consent for us to receive and use their data, call us on 01454 865337 so we can help with the enquiry.
