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Penny's Hill Practice
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PPG Constitution
Making the most of your Practice
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Doctors
Nurses
Practice Administration Team
Health Coach and Social Prescriber
Practice Pharmacist
Penny’s Hill Practice Volunteers and Friends
Practice Policies
At the Practice
Baby Friendly
Chaperones
Chaperone Policy
Clinical Governance
Clinical Research
Consent Protocol
Disability Access
Duty of Candour
Equality and Diversity
Infection Control Statement
Named GP Policy
Non-Smoking Premises
Quality Assurance
Removal of Patients from our List
Social Media
Safeguarding Children
Shared Decision Making
Unacceptable Actions Policy
Zero Tolerance
Data
Care Data
Freedom of Information
General Practice Extraction Service (GPES)
Your NHS Data Matters
Patient Record
The National Care Record Service (NCRS)
Accessing your Record
Access for Others
Subject Access Requests(SAR)
Data Sharing Preferences
Choose if data from your health records is shared for research and planning
Multi-Disciplinary Teams
Organ Donation
Sharing your Information with Others
Summary Care Record
How we use your Data
Confidentiality
Privacy Policy
Online Access
Proxy Access
Patient Rights
Complaints
Entitlement to NHS Treatment
Patient Advice and Liaison Service (PALS)
NHS Patient Rights
Your Rights and Responsibilities
Website Policies
Accessibility
Copyright
Disclaimer
Wimborne and Ferndown PCN
Physician Associate
Regulations & Governance
Clinical Commissioning Group
NHS Dorset Clinical Commissioning Group
NHS Dorset HealthCare University
GP Earnings
Care Quality Commission (CQC)
NHS Services
The NHS Constitution for England
Appointments & Tests
Appointments
NHS 111 online – Get help for your Symptoms
Consultation times
Nurse Led Clinics
Book an Appointment
Cancel an Appointment
Hospital Appointments – Book, cancel or change
Help with your GP Appointment
Self-Referral Services
Walking for Health
Citizens Advice Bureau (CAB)
Ferndown Children’s Centre
Ferndown Community Connectors
Health Coach and Social Prescriber
Physiotherapy Service
Pregnant – six weeks or more?
The Retreat – Help with coping
Lunch Clubs
Steps 2 Wellbeing
Sexual Healthcare
We are with you
Video consultations
Referral for Further Care
NHS e-Referral Tracking
Referral to Hospital by your GP
See a Doctor or Healthcare Professional
Who Do I See?
Tests & Investigations
Access Your Test Results
Hospital Blood Testing
Other Common Tests
Urine Tests
X-Rays & Scans
What is a Blood Test?
Clinics & Services
Clinics
Antenatal Care
Child Health Checks
Clinics we provide
Long Term Conditions
NHS Health Check aged 40 – 74
Travel Clinic & Holiday Vaccinations
Online Services
Register for Online Services
NHS App
Practice Services
Advocacy Service
Dementia Services
Cervical Screening
Diabetes Services
Hepatitis B Immunisation
Register with us as a New Patient
Further Help about how to Register with a GP
Registration Policy
Temporary Services
Housebound & Older People
Home Visits
Interpreting Service
New Medicine Service (NMS)
Non NHS Services – Chargeable
Order a Repeat Prescription
Antibiotic Use
Changes to your medicines
Wasted Medications
Electronic Prescriptions
Patient Transport Advice Centre
Sick or Fit Note
Texting Service
Your Care
Disability
British Deaf Association
Autism
Action on Hearing Loss
Contact – for Families with Disabled Children
Disability Rights UK
Deaf or Hard of Hearing
Get Active with a Disability
How to Care for a Disabled Child
Learning Disability
National Autistic Society
SCOPE – Equality for Disabled People
Vision Impairment
Health and Wellbeing
Children’s Health
Change4Life
Children and Young People’s Services
Childline
ERIC – The Children’s Bowl & Bladder Charity
Looking after your Child’s Health
Triple P – Positive Parenting Programme
Your Guide to Childrens Coughs, Colds, Earache & Sore Throats
General Health Advice
More about Sprains and Strains
Antibiotic Awareness
Food Allergy
Diarrhoea and Vomiting – Do’s and Don’ts
Healthcare Associated Infection
Vitamin B12 or folate deficiency anaemia
Managing an Infection
Menopause
My Live Well with Pain
Know Who to Turn to for Your Healthcare
Accident & Emergency
Dentist
Hospitals
NHS Out of Hours Services
Optician
Pharmacist
Lifestyle Changes
Alcohol & Drug Services
Healthy Eating
Physical Activity – The Single best Medicine
Social Prescribing
Weight Management
Stop Smoking Service
Long Term Conditions
Asthma
Breast Cancer (female)
Chronic Obstructive Pulmonary Disease (COPD)
Coronary Heart Disease
Dementia
Dementia with Lewy bodies
Diabetes
Epilepsy
High Blood Pressure (Hypertension)
Osteoarthritis
Prostate Cancer
Testicular Cancer – Check Yourself
Mental Wellbeing
Depression
The Retreat – Help with coping
Doc Ready
Dealing with a Mental Health Crisis or Emergency
Every Mind Matters
Feeling down or anxious? Beating the Blues 24/7 can help…
Healthtalk
Lifelink
Making Space
Mind – for better Mental Health
Mental Health Helplines
Mental Health – General Advice
Mental Health Issues if you’re Gay, Lesbian or Bisexual
Rethink Mental Illness
Samaritans
SANE
Time to Change
Pregnancy & Baby
Am I Pregnant?
Self-refer for antenatal care
CRY-SIS Helpline
Maternity Services Locations
Postnatal Care
Postnatal Depression
Smoking affects your Unborn Baby
Start 4 Life
Sexual Health & Sexuality
Contraceptive Advice & Sexual Health
Your Contraception Guide
Free Condoms
Gender Dysphoria
LGBT Foundation
Maria Stopes UK
Sexual Healthcare
Sexually Transmitted Disease
Preventative Medicine
Annual Health Check
HPV Vaccination
Flu Vaccination
Pneumococcal vaccine
Shingles
Screening Services
Help & Support in your Area
My Life my Care
Healthier Together
Local Care/Nursing Homes
Help and Support Organisations
Age UK
DrugFAM
Bereavement
At a Loss
Family Lives
Humankind
Health Unlocked
Motor Neurone Disease Association (MNDA)
MS Society
Orchid – Fighting Male Cancer
Shelter- England
Same You
The Pavement
The Brain Tumour Charity
Palliative Care information
Cancer Support Services
End of Life Care
#hellomynameis
Together for short Lives
What end of life care involves
Supporting Others
Services for Carers
Carers UK
Your Record
Keep us up to Date
Change of Contact Details Form
Register as a Carer Form
Register for Online Services Form
Summary Care Record Opt-out Form
Communication Consent Form
Health Review Forms
Alcohol Consumption Review Form
Asthma Review Form
Blood Pressure Review Form
Breathlessness Review Form
Epilepsy Review Form
Male Urinary Tract (IPSS) Review Form
Mental Health Review (PHQ-9) Form
Smoking Review Form
Travel Risk Assessment Form
Young People
Bitesize
Can I see the GP or Nurse on my own?
Kooth
The Mix
Sexual Healthcare
Teenage Friendly
Young Minds
Podcasts
Penny’s Hill Practice Podcasts A-Z
Penny’s Hill Practice Podcast Season Two
Penny’s Hill Practice Podcast Season One
Penny’s Hill Practice Podcast Specials
Penny’s Hill Practice Podcast New baby special
Coronavirus
Menu
Home
About Us
Contact
Contact Telephone Numbers
Friends & Family Test
Location
Opening Hours
Opening times
What to do when we are closed
Signing Up For Patient Participation Group
Subject Access Request (SAR)
Send a Message
Equipment & Funding
Have your Say
Practice Survey Reporting
Compliments and Suggestions
Friends and Family Test
Complaints
Patient Opinion
Patient Participation Group
PPG Meeting Minutes & Annual Reports
PPG Constitution
Making the most of your Practice
Our Team
Doctors
Nurses
Practice Administration Team
Health Coach and Social Prescriber
Practice Pharmacist
Penny’s Hill Practice Volunteers and Friends
Practice Policies
At the Practice
Baby Friendly
Chaperones
Chaperone Policy
Clinical Governance
Clinical Research
Consent Protocol
Disability Access
Duty of Candour
Equality and Diversity
Infection Control Statement
Named GP Policy
Non-Smoking Premises
Quality Assurance
Removal of Patients from our List
Social Media
Safeguarding Children
Shared Decision Making
Unacceptable Actions Policy
Zero Tolerance
Data
Care Data
Freedom of Information
General Practice Extraction Service (GPES)
Your NHS Data Matters
Patient Record
The National Care Record Service (NCRS)
Accessing your Record
Access for Others
Subject Access Requests(SAR)
Data Sharing Preferences
Choose if data from your health records is shared for research and planning
Multi-Disciplinary Teams
Organ Donation
Sharing your Information with Others
Summary Care Record
How we use your Data
Confidentiality
Privacy Policy
Online Access
Proxy Access
Patient Rights
Complaints
Entitlement to NHS Treatment
Patient Advice and Liaison Service (PALS)
NHS Patient Rights
Your Rights and Responsibilities
Website Policies
Accessibility
Copyright
Disclaimer
Wimborne and Ferndown PCN
Physician Associate
Regulations & Governance
Clinical Commissioning Group
NHS Dorset Clinical Commissioning Group
NHS Dorset HealthCare University
GP Earnings
Care Quality Commission (CQC)
NHS Services
The NHS Constitution for England
Appointments & Tests
Appointments
NHS 111 online – Get help for your Symptoms
Consultation times
Nurse Led Clinics
Book an Appointment
Cancel an Appointment
Hospital Appointments – Book, cancel or change
Help with your GP Appointment
Self-Referral Services
Walking for Health
Citizens Advice Bureau (CAB)
Ferndown Children’s Centre
Ferndown Community Connectors
Health Coach and Social Prescriber
Physiotherapy Service
Pregnant – six weeks or more?
The Retreat – Help with coping
Lunch Clubs
Steps 2 Wellbeing
Sexual Healthcare
We are with you
Video consultations
Referral for Further Care
NHS e-Referral Tracking
Referral to Hospital by your GP
See a Doctor or Healthcare Professional
Who Do I See?
Tests & Investigations
Access Your Test Results
Hospital Blood Testing
Other Common Tests
Urine Tests
X-Rays & Scans
What is a Blood Test?
Clinics & Services
Clinics
Antenatal Care
Child Health Checks
Clinics we provide
Long Term Conditions
NHS Health Check aged 40 – 74
Travel Clinic & Holiday Vaccinations
Online Services
Register for Online Services
NHS App
Practice Services
Advocacy Service
Dementia Services
Cervical Screening
Diabetes Services
Hepatitis B Immunisation
Register with us as a New Patient
Further Help about how to Register with a GP
Registration Policy
Temporary Services
Housebound & Older People
Home Visits
Interpreting Service
New Medicine Service (NMS)
Non NHS Services – Chargeable
Order a Repeat Prescription
Antibiotic Use
Changes to your medicines
Wasted Medications
Electronic Prescriptions
Patient Transport Advice Centre
Sick or Fit Note
Texting Service
Your Care
Disability
British Deaf Association
Autism
Action on Hearing Loss
Contact – for Families with Disabled Children
Disability Rights UK
Deaf or Hard of Hearing
Get Active with a Disability
How to Care for a Disabled Child
Learning Disability
National Autistic Society
SCOPE – Equality for Disabled People
Vision Impairment
Health and Wellbeing
Children’s Health
Change4Life
Children and Young People’s Services
Childline
ERIC – The Children’s Bowl & Bladder Charity
Looking after your Child’s Health
Triple P – Positive Parenting Programme
Your Guide to Childrens Coughs, Colds, Earache & Sore Throats
General Health Advice
More about Sprains and Strains
Antibiotic Awareness
Food Allergy
Diarrhoea and Vomiting – Do’s and Don’ts
Healthcare Associated Infection
Vitamin B12 or folate deficiency anaemia
Managing an Infection
Menopause
My Live Well with Pain
Know Who to Turn to for Your Healthcare
Accident & Emergency
Dentist
Hospitals
NHS Out of Hours Services
Optician
Pharmacist
Lifestyle Changes
Alcohol & Drug Services
Healthy Eating
Physical Activity – The Single best Medicine
Social Prescribing
Weight Management
Stop Smoking Service
Long Term Conditions
Asthma
Breast Cancer (female)
Chronic Obstructive Pulmonary Disease (COPD)
Coronary Heart Disease
Dementia
Dementia with Lewy bodies
Diabetes
Epilepsy
High Blood Pressure (Hypertension)
Osteoarthritis
Prostate Cancer
Testicular Cancer – Check Yourself
Mental Wellbeing
Depression
The Retreat – Help with coping
Doc Ready
Dealing with a Mental Health Crisis or Emergency
Every Mind Matters
Feeling down or anxious? Beating the Blues 24/7 can help…
Healthtalk
Lifelink
Making Space
Mind – for better Mental Health
Mental Health Helplines
Mental Health – General Advice
Mental Health Issues if you’re Gay, Lesbian or Bisexual
Rethink Mental Illness
Samaritans
SANE
Time to Change
Pregnancy & Baby
Am I Pregnant?
Self-refer for antenatal care
CRY-SIS Helpline
Maternity Services Locations
Postnatal Care
Postnatal Depression
Smoking affects your Unborn Baby
Start 4 Life
Sexual Health & Sexuality
Contraceptive Advice & Sexual Health
Your Contraception Guide
Free Condoms
Gender Dysphoria
LGBT Foundation
Maria Stopes UK
Sexual Healthcare
Sexually Transmitted Disease
Preventative Medicine
Annual Health Check
HPV Vaccination
Flu Vaccination
Pneumococcal vaccine
Shingles
Screening Services
Help & Support in your Area
My Life my Care
Healthier Together
Local Care/Nursing Homes
Help and Support Organisations
Age UK
DrugFAM
Bereavement
At a Loss
Family Lives
Humankind
Health Unlocked
Motor Neurone Disease Association (MNDA)
MS Society
Orchid – Fighting Male Cancer
Shelter- England
Same You
The Pavement
The Brain Tumour Charity
Palliative Care information
Cancer Support Services
End of Life Care
#hellomynameis
Together for short Lives
What end of life care involves
Supporting Others
Services for Carers
Carers UK
Your Record
Keep us up to Date
Change of Contact Details Form
Register as a Carer Form
Register for Online Services Form
Summary Care Record Opt-out Form
Communication Consent Form
Health Review Forms
Alcohol Consumption Review Form
Asthma Review Form
Blood Pressure Review Form
Breathlessness Review Form
Epilepsy Review Form
Male Urinary Tract (IPSS) Review Form
Mental Health Review (PHQ-9) Form
Smoking Review Form
Travel Risk Assessment Form
Young People
Bitesize
Can I see the GP or Nurse on my own?
Kooth
The Mix
Sexual Healthcare
Teenage Friendly
Young Minds
Podcasts
Penny’s Hill Practice Podcasts A-Z
Penny’s Hill Practice Podcast Season Two
Penny’s Hill Practice Podcast Season One
Penny’s Hill Practice Podcast Specials
Penny’s Hill Practice Podcast New baby special
Coronavirus
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Breathlessness Review Form
Breathlessness Review Form
Breathlessness Review
First Name
*
Last Name
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Email
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Enter Email
Confirm Email
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Confirm Email
Date of birth
*
Please use format day/month/year e.g. 12/05/1979
Phone Number
*
Your Breathlessness Review
How do you rate your level of breathlessness?
*
I’m not troubled by breathlessness
I get breathless when I undertake vigorous exercise
I get short of breath when hurrying or walking up slopes
When walking I have to stop from time to time or walk slower due to breathlessness
I have to stop for breath after a few minutes of walking a short distance on level ground
I’m too breathless to leave the house and get breathless when getting dressed
Privacy Policy
This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our
Privacy Policy
to discover how we protect and manage your submitted data.
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