Referral request

Use this service to request a referral from a doctor.

You can use this service if you:

• are registered at the surgery

Our website should not to be used to request medication.

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of

Start now

You can also phone us on Market Harborough Medical Centre 01858 464242 or St Luke’s Branch Surgery 01858 464242 or Husbands Bosworth Medical Centre 01858 880522.