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Ethnicity data

Use this service to provide us with your ethnicity data.

In line with government guidance, we are asking our patients to inform us of their ethnicity to complete their medical record. Covid-19 has affected certain populations in the UK differently, so in order to plan recovery in a way that inclusively supports those at greater risk, it is important we have this data on record.

You can use this service if you:

  • are registered at the surgery

Before you start

We’ll ask you for:

  • your first and last name, date of birth, sex, postcode, email and phone number
  • if applicable, the details of the person you are completing the form on behalf of
Start now

You can also phone us on Glyndon Medical Centre 020 8854 6444 or Samuel Street Surgery 020 8854 1222.