Umbrella Enquiry Form

We offer a range of sexual health services including the fitting and removal of contraceptive coils and implants, as well as chlamydia screening for young people age 15 – 24.

You do not have to be a registered patient at The Kings Norton Surgery or Ash Tree Surgery to access these services.

Just complete the contact form below, and we will get in touch to discuss your needs.


Umbrella Sexual Health self-referral
Name
Name
First
Last
Home Address
Home Address
City
County
Postcode