VICTORIA ROAD SURGERY

50 Victoria Road, Worthing, West Sussex, BN11 1XE

Telephone: 01903 230656

Sorry, we're closed

Durrington Health Centre, Durrington Lane, Worthing, West Sussex, BN13 2RX | Telephone: 01903 230656

Bowel Cancer. Help us, Help you WHEN STROKE STRIKES, ACT F.A.S.T Cervical Cancer Prevention

Useful Forms, Leaflets & Websites

Health for Kids Poster

Chathealth

Prediabetes Leaflet gives information on prediabetes

Staying Well – Southdown 24/7 Walk in service

Prostate PSA Advice gives information on prostate testing and cancer

Earwax Care Leaflet  gives information on clearing earwax

Asthma Annual Review Questionnaire  use this form if you do not wish to attend Surgery for your annual asthma review

Time to Talk Leaflet 2017   Time to Talk offer a range of talking therapies

Self-referral form Physiotherapy 2024

PHQ-GAD7 (Web) Depression and anxiety screening

Third Party Consent Form giving permission to discuss a third party’s medical information

Change of Name or Address  Form to inform us of change of details

Contraceptive Pill Request Form to request contraceptive pill

Urine Sample Test Form Form to give information on urine sample (please fill out one of the forms only)

Carer’s Registration Form Oct 09[1]

Shoulder Exercises

Victoria Road On Line Access Information Sheet

Victoria Road On Line Access Application Form

Type 1 Opt Out Form Stops your personally identifiable patient data being shared outside of your GP Practice unless it is for your care

Home Blood Pressure Recording Sheet Form for recording your home bp readings

WEBSITES

Carers Support West Sussex are running a series of early-bereavement workshops to support carers who have been bereaved within the last six months. There is no age-constraint with these workshops.  See www.carerssupport.org.uk/bereavement-workshops

 

SurgeryWeb

Staff Login | Privacy Policy | Accessibility

Accessibility Tools

Privacy settings

Decide which cookies you want to allow. You can change these settings at any time. However, this can result in some functions no longer being available. For information on deleting the cookies, please consult your browser’s help function. Learn more about the cookies we use.

With the slider, you can enable or disable different types of cookies:

This website will:

  • Essential: Remember your cookie permission setting
  • Essential: Allow session cookies
  • Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
  • Essential: Keep track of what you input in a shopping cart
  • Essential: Authenticate that you are logged into your user account
  • Essential: Remember language version you selected

This website won't:

  • Remember your login details
  • Functionality: Remember social media settings
  • Functionality: Remember selected region and country
  • Analytics: Keep track of your visited pages and interaction taken
  • Analytics: Keep track about your location and region based on your IP number
  • Analytics: Keep track of the time spent on each page
  • Analytics: Increase the data quality of the statistics functions
  • Advertising: Tailor information and advertising to your interests based on e.g. the content you have visited before. (Currently we do not use targeting or targeting cookies.
  • Advertising: Gather personally identifiable information such as name and location

This website will:

  • Essential: Remember your cookie permission setting
  • Essential: Allow session cookies
  • Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
  • Essential: Keep track of what you input in a shopping cart
  • Essential: Authenticate that you are logged into your user account
  • Essential: Remember language version you selected
  • Functionality: Remember social media settings
  • Functionality: Remember selected region and country

This website won't:

  • Remember your login details
  • Analytics: Keep track of your visited pages and interaction taken
  • Analytics: Keep track about your location and region based on your IP number
  • Analytics: Keep track of the time spent on each page
  • Analytics: Increase the data quality of the statistics functions
  • Advertising: Tailor information and advertising to your interests based on e.g. the content you have visited before. (Currently we do not use targeting or targeting cookies.
  • Advertising: Gather personally identifiable information such as name and location

This website will:

  • Essential: Remember your cookie permission setting
  • Essential: Allow session cookies
  • Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
  • Essential: Keep track of what you input in a shopping cart
  • Essential: Authenticate that you are logged into your user account
  • Essential: Remember language version you selected
  • Functionality: Remember social media settings
  • Functionality: Remember selected region and country
  • Analytics: Keep track of your visited pages and interaction taken
  • Analytics: Keep track about your location and region based on your IP number
  • Analytics: Keep track of the time spent on each page
  • Analytics: Increase the data quality of the statistics functions

This website won't:

  • Remember your login details
  • Advertising: Use information for tailored advertising with third parties
  • Advertising: Allow you to connect to social sites
  • Advertising: Identify device you are using
  • Advertising: Gather personally identifiable information such as name and location

This website will:

  • Essential: Remember your cookie permission setting
  • Essential: Allow session cookies
  • Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
  • Essential: Keep track of what you input in a shopping cart
  • Essential: Authenticate that you are logged into your user account
  • Essential: Remember language version you selected
  • Functionality: Remember social media settings
  • Functionality: Remember selected region and country
  • Analytics: Keep track of your visited pages and interaction taken
  • Analytics: Keep track about your location and region based on your IP number
  • Analytics: Keep track of the time spent on each page
  • Analytics: Increase the data quality of the statistics functions
  • Advertising: Use information for tailored advertising with third parties
  • Advertising: Allow you to connect to social sitesl Advertising: Identify device you are using
  • Advertising: Gather personally identifiable information such as name and location

This website won't:

  • Remember your login details
Save & Close