my.drdoctor.co.uk Open in urlscan Pro
20.108.244.236  Public Scan

Form analysis
1 forms found in the DOM

POST /quick-question/22bab543-29bb-4c54-9282-39a1a3b58a1b

<form method="post" action="/quick-question/22bab543-29bb-4c54-9282-39a1a3b58a1b">
  <div class="user-generated-content">
    <p>Dear Patient,</p>
    <p>You are listed on our Upper GI Surgery&nbsp;waiting list <strong>for</strong> an appointment at one of our hospitals, which include Heartlands, Good Hope, Solihull and Queen Elizabeth.</p>
    <p>We often find that some patients no longer need to be seen, either because they have already been seen elsewhere, or because their condition has improved. Please confirm whether or not you still wish to remain on the outpatient waiting list by
      responding with one of the options below.</p>
    <ul>
      <li>If you wish to remain on the outpatient waiting list, respond YES</li>
      <li>If you no longer need an appointment, respond NO</li>
      <li>If you are unsure if you require an appointment or need further information, respond UNSURE and add comments to help us understand your query. We will contact you to discuss this further.</li>
    </ul>
    <p>Please respond by 30/06/2024.</p>
  </div>
  <div class="quick-question-options" id="question-list-options">
    <p>
      <label>
        <input type="radio" name="response" value="yes" class="sr-only">
        <span>Yes</span>
      </label>
    </p>
    <p>
      <label>
        <input type="radio" name="response" value="no" class="sr-only">
        <span>No</span>
      </label>
    </p>
    <p>
      <label>
        <input type="radio" name="response" value="unsure" class="sr-only">
        <span>Unsure</span>
      </label>
    </p>
  </div>
  <div class="actions">
    <input type="hidden" name="NCSRF" value="RandomBytes#yw07g236frxpIw==|Hmac#V8zGAkn7bjNTj9v39VJ0w2txJDKEauEVLSbbe4E1K6g=|CreatedDate#2024-06-27T09:37:40.7921571+01:00">
    <input type="hidden" name="askForComment" value="True">
    <input type="submit" value="Next" class="button -subtle" id="question-next-button" disabled="">
  </div>
</form>

Text Content

COOKIES

We use essential cookies to help improve your experience. Learn more.

OK

Dear Patient,

You are listed on our Upper GI Surgery waiting list for an appointment at one of
our hospitals, which include Heartlands, Good Hope, Solihull and Queen
Elizabeth.

We often find that some patients no longer need to be seen, either because they
have already been seen elsewhere, or because their condition has improved.
Please confirm whether or not you still wish to remain on the outpatient waiting
list by responding with one of the options below.

 * If you wish to remain on the outpatient waiting list, respond YES
 * If you no longer need an appointment, respond NO
 * If you are unsure if you require an appointment or need further information,
   respond UNSURE and add comments to help us understand your query. We will
   contact you to discuss this further.

Please respond by 30/06/2024.

Yes

No

Unsure



Visit our help section

Service provided by DrDoctor