<p> The Health Centre</p><p>«Date» «PATIENT_Title» «PATIENT_Forename1» «PATIENT_Surname» «PATIENT_BlockAddress»</p><p>Dear Patient,</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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</p><p>Yours sincerely</p><p>Dr & Partners</p><p>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______</p>