Smoking Review

If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.

Smoking Review

Smoking Review

About You

Please use this date format: DD/MM/YYYY.
Responses we send will go to this email address

Smoking Review

Do you currently smoke?

Do not currently smoke section

Have you smoked in the past?
How many cigarettes did you smoke in a day?

Do currently smoke section

How many cigarettes do you smoke in a day?
Would you like to give up smoking?
If you are interested in stopping smoking, you can self-refer to Smoke Free Life Berkshire, or telephone 0800 622 6360.

Clinics are held in the following locations 3 days a week:

Monday - Strawberry Hill Medical Centre
Tuesday - Tesco on Pinchington Lane
Saturday - Newbury Market