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Rainbow Medical Centres NHS GP Surgeries in St Helens

Including ethnicity in your health record

Ethnicity Data

Patient Details

Full Name: *

Date of Birth: *

Please use this date format: DD/MM/YYYY

Email Address: *

Any responses we send will go to this email address

Phone Number:

Ethnicity

Please specify the ethnic group you consider you belong to: *

White – British

White – Irish

Gypsy or Irish Traveller

Any other White background

Mixed White and Black Caribbean

Mixed White and Black African

Mixed White and Asian

Any other Mixed / Multiple ethnic background

Asian or Asian British – Indian

Asian or Asian British – Pakistani

Asian or Asian British – Bangladeshi

Any other Asian background

Black or Black British – African

Black or Black British – Caribbean

Any other Black / African / Caribbean background

Chinese

Arab

Other ethnic group

I do not wish to state

Please specify: *

If you are human, leave this field blank.

The Sutton Surgery
333 Robins Lane
Sutton
St Helens
Merseyside
WA9 3PN

Get directions

01744 811211

Thatto Heath Surgery
99 Elephant Lane
Thatto Heath
St Helens
Merseyside
WA9 5QL

Get directions

01744 811211

Register with the surgery

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