Sore throats – Radcliffe Medical Practice

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You can complete this form for yourself or your child.

Does your query relate to a child under 1 year old?*

Yes

Your request cannot be completed online please contact the surgery on 0161 724 2062 for further healthcare advice.

This form is not for urgent medical help

Minor health conditions*

This form is for minor health conditions only. It should not be used by anyone who has:

Signs of a heart attack - pain like a very tight band, heavy weight or squeezing in the centre of your chest.
Signs of a stroke - face drooping on one side, can’t hold both arms up, difficulty speaking.
Severe drowsiness, confusion or unconsciousness (can't be woken up).
Severe difficulty breathing - gasping, not being able to get words out, choking or lips turning blue.
Sudden rapid swelling of the eyes, lips, mouth, throat or tongue.
Heavy bleeding - that won’t stop.
Severe injuries - or deep cuts after a serious accident.
Seizure (fit) - someone is shaking or jerking because of a fit, or is unconscious (can’t be woken up).

Do you have any of the symptoms above?

Yes

Please call 999 or attend A+E

Your details

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Date of birth*

First name(s)*

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Email address*

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Sore throat form questions

Do you or your child have a sore throat and the following is true?*

You (or your child) make a high pitched sound when trying to breathe
You (or your child) feel very ill and have pain on one side of the throat only
You (or your child) are drooling saliva (you are unable to swallow even saliva)
You (or your child) have been told by your doctor to seek medical help straight away if you get a sore throat - because you are taking medication which may suppress your immune system
You (or your child) have taken high dose steroid tablets (at least 40mg a day for a week or more or 20mg a day for 10 days or more) in the last month
You (or your child) are having treatment for blood cancer (eg leukaemia, lymphoma).
You (or your child) are having difficulty in breathing

Yes

None of the above

Key symptoms*

Please tick which symptoms you have from the list below:

Fever of 38°C or higher in the last 24 hours

Sore throat without a cough or other cold symptoms (runny nose etc)

Symptoms which have come on rapidly, in the last 3 days or less

Your tonsils (at the back of your throat if you look in the mirror with a torch) look red and inflamed

White pus on your tonsils (at the back of your throat if you look in the mirror with a torch).

Are you (or the person you're completing this form for)*

5 years old or older

Under 5 years old

Do any of these apply to you (or the person you're completing this form for)?*

You have had your tonsils removed
You have had antibiotics for this episode of sore throat, but you have not got better
You have had severe sore throat or tonsillitis 5 or more times every year for the last 2 years
You have had severe sore throat or tonsillitis 7 or more times in the last year
You have had severe sore throat or tonsillitis 3 or more times every year for the last 3 years

Yes

None of the above

Your request cannot be completed online please contact the surgery on 0161 724 2062 for further healthcare advice.

Confirm and submit the form

This service is intended for electronic communication between you and your healthcare provider. The information may be read by your Pharmacist or a designated member of the GP or Pharmacy team. By submitting this form you consent to your information being shared.

This form is not for urgent medical help

Your details

Sore throat form questions

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