Adult Asthma
Questionnaire

Make an Appointment

03300 536456

Request an Appointment Online

Health Co-Pilot

Adult Asthma Questionnaire

Required fields are marked with an asterisk (*).

An exacerbation is where your symptoms got worse, your reliever did not help and you needed to seek medical attention.

Enter an approximate number is fine here.

Please not that your answers will not be seen immediately and you should direct any urgent queries to your healthcare team

Please not that ‘smoking status’ refers to smoking tobacco products, and NOT the use of e-cigarettes or ‘vaping’. If you only use e-cigarettes or ‘vape’ then please select ‘Ex-smoker’ (if you used to smoke tobacco products or ‘Never smoked’.

Please not that your answers will not be seen immediately and you should direct any urgent queries to your healthcare team

Privacy Consent – This form collects personal and medical information about you/ We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage submitted data.

We're here for you

Mental Health Resources

COPD Questionnaire
Information, help and guidance in relation to mental health
Adult Asthma Questionnaire
Directory of information and support for your mental health

Other forms available

Register as Patient
Please visit our Patient Registration page and fill in the health questionnaire to register as a patient at Teldoc.
Change of Contact Details
If you need to update your email or contact number, then please use this form
More Self-Referral and Review Forms
Visit here for more self-referral, review forms and services
More forms
Please visit the How Do I Portal for more forms

Find out more...

https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2023/05/card_image_07.jpg

Latest News at the Surgery

All the latest news from Shifnal & Priorslee Medical Practice, the NHS and other health services

READ MORE
https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2021/07/card_image_01.jpg

Vaccination Information

All the latest vaccination clinic dates and locations and latest vaccination news from Teldoc PCN and NHS

READ MORE
https://shifnalandpriorsleemp.co.uk/wp-content/uploads/2023/05/card_image_14-1.jpg

Visit the How Do I Portal

Visit the How Do I portal for information on how to make an appointment, register at the practice and change your details 

READ MORE
More Information
Shifnal & Priorslee Medical Practice
Quick Links
Connect
01952 460 414
Haughton Road, Shifnal, Shropshire, TF11 8DD
Gatcombe Way, Priorslee, Telford, TF2 9GZ
CQC

Inspected and rated

Good

©2026 Teldoc Primary Care Network. All rights reserved. Site design by JC @ PCDS

Update - Please note the practice will be closed from 6.00pm on Thursday 2nd April until 8.00am on Tuesday 7th April due to the Bank Holiday.

Think which service? - NHS Shropshire, Telford and Wrekin (shropshiretelfordandwrekin.nhs.uk) Please dial 111 for any non-urgent medical issue that cannot wait until the practice reopens. As always please only dial 999 for any urgent/life threatening matters.

This will close in 15 seconds

error: Content is protected !!
Skip to content