Smoking Review

If you have been invited to submit a smoking review by your doctor,
or if you would like to keep us up-to-date,
please complete this form.

Smoking Review

Smoking Review

About You

Please use this date format: DD/MM/YYYY.

Smoking Review

Do not currently smoke section

Do currently smoke section

If you would like help to stop smoking please make an appointment with one of our nurses or a local pharmacist.
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