Useful Patient Forms & Documents

The following links will allow you to view a number of documents and forms, including self-referral forms, our travel vaccination questionnaire and our change of address form.

Change of address

• Change of Address form

Self-referrals

• Physiotherapy self-referral form
• Podiatry self-referral form
• Occupational Therapy self-referral form
• Antenatal Care self-referral form
• Older People’s Short Term Assessment Team self-referral information
• Mental Health Services self-referral information
• Northern Ireland Primary Eyecare Assessment and Referral Scheme (PEARS) information

Your Health Records

• Access to health records request form

Travel Vaccinations

From 1st September 2022 we will no longer offer travel advice. Patients can contact local travel clinics for advice:

• Bangor Travel Clinic, Silverbirch Medical Centre. Tel 02891 455000
• Boots Chemist, Bloomfield Shopping Centre, Bangor. Tel 02891 271030
• Belfast Travel Clinic, Kerrsland Surgery. Tel 02890 657138

Sickness & Sick Pay

• SC2 form for reporting sickness and claiming SSP