Patient Registration

If you are not currently a patient of the Practice, you live within our practice boundary and you wish to register, you simply need to call into the surgery for a registration pack.  Alternatively, please print off the documents below, complete them and bring them to the surgery at your convenience.

The registration pack comprises a number of documents: -

1. A registration form, completion of which will allow us to track down your previous medical records;
2. a Health Summary - please choose the health summary for the patient which best describes you.  Attached are health summaries for adult males, adult females and children;
3. a questionnaire on your use of alcohol;
4. an ethnicity/disability form to allow the Primary Care trust to monitor new registrations.

We are required to confirm your registration details.  When you return the completed forms to us, please also bring along the following forms of ID: -

1. Passport or birth certificate; and
2. Driving license or recent utility bill which gives your current address.

Registration Form

Ethnicity & Language Form

Health Questionnaire (Adult Male)

Health Summary (Adult Female)

Health Summary (Child Under 15 )

Alcohol Usage Questionnaire