Please complete this form before you attend your Asthma review. For information on how to get the most from your asthma review click here or click here to download an Asthma Review Booklet.
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key and is accessed over a secure
connection by nominated staff. We have a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
I consent to my information being used for the purposes described above and wish to submit this online form to
Wimbledon Village Surgery
35a High Street , Wimbledon, SW19 5BY.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.