Youth Triage Form Age 13-17

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Please complete this questionnaire if you wish your symptoms be assessed by your GP Surgery. This service is only provided on Monday to Friday, 8.30am to 6.30pm. To find out more about your symptoms or condition, please visit
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When you are happy with your answers, click 'Submit' below to send the questionnaire to your GP Practice. Your GP Practice will then assess your answers and will contact you with the appropriate follow-up advice. If you have not heard anything after 48 hours, please phone your GP Practice directly.
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