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NHS Logo Rushall Medical Centre 107 Lichfield Road Rushall, Walsall, WS4 1HB | Tel: 01922 622212

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    Online Patient Forms

    The are a number of patient forms available for different purposes, please see list below:

    • New Patient Registration (GMS1)
    • Temporary Patient Registration (GMS3)
    • New Patient Health Questionnaire – Over 16 – ( to be completed after the GMS1)
    • New Patient Health Questionnaire – Under 16 – ( to be completed after the GMS1)
    • Register for Online Services
    • Repeat Prescription Request
    • PPG Sign Up
    • Access to Medical Records Request
    • Third Party Authorisation
    • Proxy Access
    • Complaints Form
    • FAST Alcohol Screening Tool – Audit C
    • Patient Request Form (Patient reports etc.)

    About Our Surgery

    • Practice Leaflet
    • Patient Participation Group
    • Online Patient Forms
      • Change Your Contact Details
      • Complaints
      • Third Party Authorisation
      • Access to Medical Records
      • Out of Area Consent Form
    • Closed Days
    • New Patient Registration
    • Appointments Information
    • Clinics and Services
    • Friends & Family Test
    • Meet the Team
    Rushall Medical Centre
    107 Lichfield Road
    Rushall,
    Walsall,
    WS4 1HB
    Get Directions
    01922 622212
    Opening Hours

    Monday to Friday
    7:30am to 6:30pm

    Pelsall Village Centre Branch
    Pelsall Village Centre,
    High Street,
    Pelsall,
    Walsall,
    WS3 4LX
    Get Directions
    01922 622212
    Opening Hours

    Monday to Thursday
    7:30am to 6:30pm
    Friday
    7:30am to 1:00pm

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