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New asylum seeker registration

New Asylum Seeker Registration

Patient’s Details

Title *
Please use this date format: DD/MM/YYYY
Sex *
Current hotel: *
Do you need an interpreter for appointments: *
Have you previously lived in another part of the UK? *

Appointment Details

Do you want a face-to-face new patient medical assessment with a GP? *

Tuberculosis

Do you currently have any of the following symptoms lasting for more than 3 – 4 weeks? *
Tick all that apply
Have you had tuberculosis in the past? *

Current Medical Problems

Do you have any of the following symptoms? *
Tick all that apply
Have you ever had any of the following? *
Tick all that apply

Mental Health

Do you currently have any of the following symptoms? *
Tick all that apply