Depression, Alcohol, Asthma and Smoking

This easy to use patient questionnaire has been validated for use in Primary Care.

It is used by your doctor to monitor the severity of depression and response to treatment.

It can also be used to make a tentative diagnosis of depression.

Alcohol Consumption

Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.

For patients who are due an annual asthma review.

Please would you answer the questions on the form below and submit it to us.

If your symptoms are deteriorating or you have any concerns, please make an appointment to the respiratory nurse or a doctor as well.

Smoking Cessation clinics are held at the practice on Monday mornings, to book an appointment follow:

• Call - the Living Well Stop Smoking service by phone, (01274 437700)

• Or by visiting our website https://mylivingwell.co.uk/smoking/support-to-quit for further information