Dr Singh, Garala,Godfrey,Hickson,Zurub & Dawson
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The Health Centre
«Date» «PATIENT_Title» «PATIENT_Forename1» «PATIENT_Surname» «PATIENT_BlockAddress»
Dear Patient,
We notice from your records that we have no knowledge of your smoking status and would be very grateful if you could let us know so we can update our records.
Will you please complete the tear-off slip at the bottom of this letter, giving the necessary information, and return in the enclosed stamped addressed envelope.
As part of our commitment to improving the health of our patients, this surgery is now offering support to all smokers who want to stop. If you are a smoker and would like help to stop we run a Stop Smoking Clinic here at the practice and invite you to telephone our Receptionist to make an appointment at the clinic.
Even if you have tried to stop smoking before and have been un successful, it is worth trying again – many people take more than one attempt before they stop for good.
If you have already stopped smoking or never smoked – congratulations We would be grateful if you could let us know so we can update our records
Yours sincerely
Dr & Partners
Full Name______I have never smoked______Date of birth______I am an ex smoker______Address______Years stopped______I do smoke ______How many a day ______Date______