Baby and Child Appointments

Are you both biological parents of the child? *
—Please choose an option—YesNo

Does your child weigh more than 2.5kg? *
—Please choose an option—YesNo

Was your child born prematurely? *
—Please choose an option—YesNo

If yes, at how many weeks gestation were they born?

Does your child have any current illnesses or medical conditions *
—Please choose an option—YesNo

Does your son have any Learning difficulties e.g. Autism? *
—Please choose an option—YesNo

Does your child have, or is there any family history of bleeding disorders? *
—Please choose an option—YesNo

Does your child have any foreskin problems that you are aware of? *
—Please choose an option—YesNo

Is your child on the child protection register, or under the care of social/child services? *
—Please choose an option—YesNo

If there is anything else you would like to tell us, please do so here

Finally, how did you hear about us? *
—Please choose an option—GoogleGP SurgeryMosqueRecommendation/ Word of mouthSocial Media (Instagram, Facebook, etc)Other