Online 'Pre-Registration' With The Practice
If you wish to pre-register click on the 'Pre-registration Form' link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us. When you visit the surgery for the first time for your new patient health check you will be asked to sign the form to confirm that the details are correct and you will also be required to fill out a Health Questionnaire.
We require you to fill out the Health Questionnaire because it can take a considerable amount of time for us to receive your medical records. There is a copy of this questionnaire at the bottom of the page, which you can print out and bring with you on the day of your registration appointment, or you can email it to us at firstname.lastname@example.org. It is also required that a Health Questionnaire is filled out for any person under the age of 16. This form can also be found at the bottom of the page. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.
You will be required to bring proof of address with you to your new patient health check appointment. Please do not send this electronically.
Once these forms have been forwarded to us, you will then be required to make an appointment with the Health Care Assistant , who will carry out a new patient health check. To make this appointment please telephone the surgery. Please note without this healthcheck you are NOT registered at the surgery. Please let the receptionist know at the time of your appointment that you have completed an online form.
Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.
Alternatively you may print off a registration form and questionnaire, fill it out and bring it in with you on your first visit to the practice along with your proof of address or email the forms to email@example.com.
ADULT - New Patient Health Questionnaire
UNDER 16 - New Patient Health Questionnaire