Your first visit to thePark Centre for Breast Care

Out-Patients – 3rd Floor, 177 Preston Road, Brighton

Please complete ALL of the enclosed forms and bring with you to your appointment

Many people feel anxious about coming to the Park Centre for Breast Care and what their appointment here might mean, this is quite natural. 90 percent of breast lumps and other breast symptoms are harmless and require very little treatment, or no treatment at all. We know it’s easier said than done – but please try not to worry.

About your appointmentWe try to see everyone as soon as possible after receiving the letter from their GP. If we have given you short notice of your appointment, we do apologise for any inconvenience that may cause.

If you are unable to keep this appointment please let us know by telephoning 01273 664773 as soon as possible. You can also leave a message on the answerphone after 5pm or send us an email at: breastcareOPD@bsuh.nhs.uk. If you let us know right away, we may be able to give your appointment to another patient.

We will make every effort for you to be seen as near to the time of your appointment as possible. Please be aware that if you have tests, your visit can take from one – three hours.

How should I prepare for my appointment?l You are welcome to bring a friend or relative with you.l Please bring a list of any medication you are taking.l If you have had any previous private mammograms (breast x-rays), please obtain them and bring them with you. You do not need to do this if these x-rays were taken at the Park Centre for Breast Care, Royal Sussex County Hospital, Princess Royal Hospital or any NHS Breast Screening Unit. You can obtain your private x-rays by ringing the unit that you attended and requesting them. They can be sent by post to us if you are unable to collect them. l Pleasealsobringthisleaflet,completedquestionnaireandforms.l When you arrive, please go to the reception desk on Level 3.l You will be seen by a member of our specialist team of consultant, associate specialist, clinical fellow, or nurse practitioner.

What facilities are available?l There is wheelchair access to the unit (directions enclosed) and toilet facilities for wheelchair users.l There are facilities for baby changing.l There is a League of Friends cafe on Level 3 with a selection of hot and cold drinks and light snacks.

What should I do if I have a question about my appointment?When you come to the Park Centre for Breast Care, please feel free to ask as many questions as you need to, and to voice any concerns that you may have. The doctor or nurse you will see will be happy to help.

Some questions for you to answer nowThisleafletincludesaquestionnaireandsomeformsforyoutocomplete and bring with you to your appointment. Don’t worry if you can’t answer all the questions in the questionnaire.Some of them may seem rather personal and others may seem irrelevant, but they will help us to provide the right care for you.

Please complete all the enclosed forms.

If you need to discuss your condition or treatment over the phone from home, we have a helpline where you can talk to a specialist Macmillan breast care nurse, Monday to Friday.

Call our helplineany weekday between 9am-5pm

01273 696955Ext. 4111

for information or advicefrom our specialist nurses

Rail stations London Road and Preston Park stations are all within reasonable walking distance; they serve areas within East, West and Mid Sussex.

Bus stop located outside The Park Centre for Breast Care Route 40 Mon-Fri and 40X Mon-Sat: Brighton to Cuckfield via Haywards Heath. Every 30 minutes This is free to all patients with an appointment letter.Buses 270 and 33 also stop outside the Park Centre for Breastcare.

Bus routes Stops outside the Park Centre – Route 5, 5A, 17 & 87

Stops at Preston Circus – Route 5B, 55, 56,

For further information visit www.buses.co.uk

By carPark Centre for Breast Care is situated opposite Preston Park, on the A23 which is the main road in and out of Brighton.

Parking facilities at 177 Preston RoadThere is no provision for public parking other than disabled parking. There is one disabled parking bay at the front of the building. If you need to access disabled parking, please drive to the barrier, press the intercom and entry will be given on the production of a valid disabled parking badge. There is a ‘drop off’ point half way along the north side of the building with access to the main lobby and lift. It may be necessary to ‘drop off’ a disabled visitor and for the driver to seek alternative parking.Parking is available for a charge at the nearby Travelodge Hotel.

How do I get to the Park Centre for Breast Care?

PrestonPark

LondonRoad

(Brighton)

Brighton

A23

A2010A270

A270

B2120

B2122

B2122B2121

A23

A23

A23

Preston Rd

Preston Rd

Old Shoreham Rd

Old Shoreham Rd

Hove CountyCricket Ground

Preston Park Avenue

Ditchling Rd

Preston Drove

Preston Drove

Park Centre for Breast Care

Patient Master IndexDetailsverification

Please complete details, and bring with you to your next hospital visit.Allinformationsuppliedwillbekeptstrictlyconfidential,inaccordancewiththe Data Protection Act 1988, and will be used only for the purpose of keeping your records up-to-date and for providing the administration of health care.

Trust No. NHS No.

Surname Title

Forename 1 Sex M or F

Forename 2

Forename 3

Date of birth

Home address

Postcode

Home phone Work

Mobile

e-mail address

Occupation

Religion

Nationality

Country of birth

Y / N consent to being contacted

Y / N consent to receive text reminders of appointments

Patient Master IndexDetailsverification

Ethnic GroupThisinformationisdefinedbytheDepartmentofHealth;basedonthe2001Census, and is only used for Healthcare Planning purposes.

White Mixed Asian or Asian British

White - British A White & Black Caribbean D

Indian H

White - Irish B White and Black African E

Pakistani J

White - Other C White & Asian F Bangladeshi K

Black or Black British

Any other mixed G Other Asian L

Caribbean M Other Ethnic Groups

African N Chinese R Not stated Z

Other Black P Other S Tick one box only

Next of kin Title

Relationship

Home phone

Work

N of K mobile

Registered GP

Surgery address

Marital/civil status

Pre-appointment QuestionnairePlease complete all of this questionnaire and bring it with you to your appointment

Name .............................................

DOB ...............................................

•Whatwasthefirstdayofyourlast period?

..................................................

• Cycle Frequency:

On for ............... days

every ............... days

• What age were you when you had yourfirstperiod?

.....................................years

• Have you had a hysterectomy? Yes No If yes, when? .................... years ago

• Age at menopause? (if applicable)

.......................................... years

• Were your ovaries removed?

Yes No If yes, was it: one / both / don’t know

• Have you ever taken Hormone Replacement Therapy?

Yes No If yes, for how long? ......... years/months

• Are you on Hormone Replacement Therapy now?

Yes No

• Have you ever taken the contraceptive pill? Yes No

If yes, for how long? ........... years/months

• Do you have children?

Yes No If yes, how many? ..............................

•Yourageatfirstpregnancy?

....................................years

• Did you breast feed any of your children?

Yes No • How long? ................... years/months

• Were you given medication to stop the production of breast milk?

Yes No

• Have you had a miscarriage? Yes No

• Have you ever had a mammogram/ ultrasound of breast

Yes No If yes, when last? ...........................

• Have you ever taken herbal/homeopathic medication?

Yes No If yes state ...................................

• Are you a smoker?

Yes No How many do you smoke?

• Bring list of current medication

Thank you for taking time to answer these questions

Park Centre for Breast Care177 Preston Road

Brighton East Sussex BN1 6AG

01273 696955www.bsuh.nhs.uk

Photography, design and layout: CMC – Clinical Media Centre t: 01273 696955 Ext: 4319 CMC – visualising health

© Brighton and Sussex University Hospitals NHS Trust

DisclaimerTheinformationinthisleafletisforguidancepurposesonly and is in no way intended to replace professional clinicaladvicebyaqualifiedpractitioner.

Ref number: 400.2 Publication Date: February 2017 Review Date: February 2019 carer and patient information group approved

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