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Watton Medical Practice NHS GP Surgery in South Norfolk

Ethnicity questionnaire

Ethnicity Questionnaire

Required fields are labelled

What is your name? Required

First name

Last name

What is your date of birth? Required

For example, 31 3 1980

Day

Month

Year

What is your sex? Required

As recorded on your medical record

Male

Female

Other

What is your postcode? Required

The one used to register with your GP

What is your phone number? Required

What is your email address? Required

Anyone else with access to your email account may see responses sent to you

If you are using a UK mobile number, please use the format 07xxxxxxxxx

Address:

Ethnicity

Radio Buttons

White British

White Irish

Black Caribbean

Black African

Black Caribbean and White

Black African and White

Indian

Pakistani

Bangladeshi

I do not wish to state

Other ethnic group

Please specify: Required

If you are human, leave this field blank.

24 Gregor Shanks Way
Watton
Thetford
IP25 6FA

Get directions

01953 881247

Feedback and complaints

Wellbeing

Watton Medical Practice

CQC overall rating

Good

16 April 2018

See the report

Accessibility statement

Website policies