Umbrella Sexual Health Services Request We provide coil and implant services only to patients registered with a Birmingham or Solihull GP practice. If you are not registered with one of these practices, we are unable to process your request. Please contact your local service provider for further assistance.Confirmation I confirm that I am registered with a Birmingham or Solihull GP practice.Name First Last Date of birth DD slash MM slash YYYY Phone numberEmail Enter Email Confirm Email NHS number (if known) OptionalCurrent GP surgery nameNotes OptionalServices you need: Coil Fitting Optional Coil Removal Optional Coil Replacement Optional Implant Fitting Optional Implant Removal Optional Implant Replacement Optional