23 - 37 Old Birchills, Birchills, Walsall, WS2 8QH
This form is sent to Birchills Health Centre via e-mail. Please do not use this form to submit Personal Information.
**This form is for non-clinical and non-patient queries ONLY**. Do NOT use this form to submit Personal or Clinical Information or requests as this method is NOT SECURE (Clinical Information or requests WILL NOT BE PROCESSED). For a GP Response, please use the eConsult Triage service found on our main webpage or call the practice.Thank you
This information is retained for up to 60 days.
I consent to my information being used for the purposes described above and wish to submit this online form to
Birchills Health Centre
23 - 37 Old Birchills, Birchills, Walsall, WS2 8QH.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.