GP Intervention Request

All nursing and care home staff are able to submit a GP intervention request form on behalf of their residents, who are registered patients of Drayton Medical Practice, using the link that has be sent separately to the nursing / care home.

If you have any problems accessing this link, please contact Drayton Medical Practice on 01603 867532.

  • Please ensure all requests are received before 10:30.
  • Please coordinate all referrals with one point of contact for the GP surgery to call.
  • Please meet the visiting doctor and assign a member of staff for all ward rounds.
Patient Name
Patient Date of Birth
Your Email

About the Patient's Problem

How would you like us to deal with the problem?


Please provide the readings below.
Please enter a number from 50 to 250.
Please enter a number from 20 to 300.
Please enter a number from 20 to 200.
Please enter a number from 60 to 100.
Please enter a number from 30 to 45.
Please enter a number greater than or equal to 1.
Please enter a number from 8 to 80.

Other Details

Is the patient coughing or chesty?
Please specify if the condition is acute or chronic
This field is for validation purposes and should be left unchanged.