Tell us whether you accept cookies

We've put some small files called cookies on your device to make our site work. We would also like to use analytical cookies to understand how our site is used and improve user experience. Analytical cookies send information to Google Analytics.

Let us know your preference. We will use a cookie to save your choice. Before you make your choice you can read more about our cookie policy.

Skip to main content

Ormskirk House Surgery NHS GP Surgery in St Helens

Ethnicity data

Ethnicity Data

About You

First Name(s): *

Surname: *

Date of Birth: *

Please use this date format: DD/MM/YYYY.

Email Address: *

Ethnicity

Please select your ethnic background from the options below: *

White

Mixed

Asian

Black

Other

*

English / Welsh / Scottish / Northern Irish / British

Irish

Gypsy or Irish Traveller

Caribbean

African

Asian

Any other White background

*

Any Mixed / Multiple ethnic background

*

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background

*

African

Caribbean

Any other Black background

*

Arab

Any other ethnic group

Please describe your ethnicity: *

If you are human, leave this field blank.

103 Crab Street
St Helens
Merseyside
WA10 2DJ

Get directions

01744 624808

About the surgery

Register with the surgery

Sick (fit) notes

Feedback and complaints

© Silicon Practice

Accessibility statement

Website policies