Diagnostic Ultrasound Services
Manager: Sally Hill MSc
Correspondence: Oxted Health Centre, 10 Gresham Road, Oxted, Surrey. RH8 OBQ
Tel: 01883 734000 Option 2 | Fax: 01883 713779
Email: ultrasound.oxtedhealthcentre@nhs.net
Web: www.oxtedhealthcentre.co.uk
We do require a form to book this appointment – some examinations need instructions or consent forms
Options for booking this appointment:
GP to send in via internal post /Choose & Book/Email
Patient or GP to fax to 01883 713779
Patient to Post to Oxted Health Centre or email
Patient to call in to clinic clerks between 8.30am – 12.30pm or 2pm – 4.30pm
PLEASE MAKE SURE WE HAVE THE CORRECT CURRENT ADDRESS AND CONTACT NUMBERS ON THE FORM.
SURNAME
GP:
FORENAMES
Practice:
NHS Number:
CCG:
ADDRESS
Date of Birth:
Date form sent:
Home Telephone No:
Urgent / Routine
Mobile Contact No:
Centre Preferred:
We will text you to remind you of your appointment
Oxted
NHS
Redhill Either
Work No:
Email address:
Date Received:
Tick if we may leave message for you on any of your contact details
Type of Examination: Upper Abdomen / Renal Tract / Gynae and/or Bladder/ Thyroid / Testes / Musculoskeletal/Carotid
Please circle
Other:
Clinical Problem;
Appointment Date
Aim of examination:
Please let us know if there are any physical/communication difficulties,
wheelchair user or if an interpreter is required
Diagnostic Ultrasound Services providing NHS services on behalf of NHS Surrey, West Kent & West Sussex