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Upload a Clinical Letter

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Clinical Letter Upload Form

Required fields are marked with an asterisk (*).
If you have a clinic letter from an out of area hospital or clinic that you would like us to add to your electronic medical record, or if you have seen a Shifnal & Priorslee Medical Practice Clinician recently, who has requested a copy of a letter to be added to your records, please complete the form below. *Please note, we DO NOT accept Blood pressure diaries or Images via this form*
Please provide your details below
Please upload here (Maximum upload of two documents)
  • Please make sure you are uploading the original document only; we do not accept photocopies or poor photo quality of documents taken on mobile phones
  • Please save as a word document only, other formats will not be accepted.
  • Please make sure you upload the document in full, including any blank numbered pages within the document
  • The document must be written in English or have a full translation to English before upload
  • If you are uploading a “power of attorney”, please make sure you have both the Notification to register document and the 22-page document in full

*Please make sure all Mandatory fields have been completed

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Please note this form is not to be used for the following purposes:

Medical matters, Prescription requests, Patient Access requests, Appointment requests or Complaints. Medical matters cannot be dealt with via this form. If you have a query regarding a medical matter please telephone reception to make an appointment to see the appropriate person.

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