Reception: Steroid Injection Consent Form

Please complete this form if you are interested in having a steroid injection at the practice. Prior to completing the form please review in full the information in the link below outlining the benefits and risks of the procedure.

Due to the COVID19 pandemic we are following key guidance on the use of steroid injections during peak periods of infection. Steroids impact the bodies ability to fight infections and therefore should be used with caution. Therefore, following this guidance we have implemented a number of key addition steps which must be completed.

These are

  1. The GP will review your safety to have the injection on reciept of a completed online form.
  2. You must have no COVID19 symptoms on the day of your appointment. If you do you must cancel this appointment and book a test.
  3. You must complete a COVID19 test 7 days prior to your appointment regardless of if you do not have any symptoms or if you are currently shiedling. No injection will be done without proof of test. This can be done via home testing (lateral flow test).
  4. Full PPE will be worn by the clinician and the patient is to wear a facemask
Please do not write any clinical queries on this form. Any clinical queries or request for appointments via this form will be discarded. To make an appointment either book online via the NHS app/Patient access or by calling reception. We will start to process your form by the next working day but it will take up to 3 working days to complete. Please DO NOT call before 3 working days as you will not receive a status update from reception or the administrative team. If you are NOT a registered patient then your form will be discarded. This service is only for patients registered at the surgery aged 16 and over.
Reception: Steroid Injection Consent Form
Only one joint can be done at one time.
If you select the option 'I do not want to go ahead' you will not be booked for a steroid injection and you can abandon this form
Please note not all patients will need to be contacted. This will be done on a case by case basis.
If you select 'No' then unfortunately we will be unable to complete a steroid injection for you at this time.
Having a steroid injection 4 weeks before or after the COVID vaccine can lead to a poor response and impact your protection

Please note: if you experience a fever (>37.8C) or a persistent cough (>4 hours) do not attend your appointment at the surgery. Instead cancel your appointment and self-isolate for 14 days and book a test.

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All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

Local Services, Let
Local Services, Let