New Patient Registration

If you live within our boundary area and would like to register with the practice please use this form.

You can also download, complete and bring both registration forms into the surgery.

New patients living in the catchment area can register after completing the registration form, bringing any requested proof of residency and entitlement to NHS care and attending the registration clinic with the health care assistant. You will be provided with a New Patient Information Booklet upon registering.

Out of Area Registrations

We may consider your request to register even if you live outside our Practice boundaries. This is because it may be more convienient for you to register with a Practice near to your place of work for example. We will do this on the basis that you will be unable to recieve home visits from our Practice, and these will be provided where necessary, by a surgery close to your home.

It is important to remember that if you are likely to require more than 2 home visits per year, or you have complex health needs that require intensive support, that your out of are registration will be refused.

View more information on out of area registrations.

Temporary Registration

You can register as a temporary resident if you plan to live near the surgery for up to three months. You can register temporarily with a GP while away from home for work, study or holiday. You’ll still remain registered with your permanent GP.

Registration Details

Please use this date format: DD/MM/YYYY.

Nationality

Please help us trace your previous medical records by providing the following information

Please include postcode.

If you are from abroad

Please use this date format: DD/MM/YYYY.

If you are returning from the Armed Forces

Please use this date format: DD/MM/YYYY.

If you are registering a child under 5:

If you need your doctor to dispense medicines and appliances

Electronic Prescription Service (EPS)

The Electronic Prescription Service (EPS) is a NHS service that allows us to send your prescription(s) directly to your chosen pharmacy. This paper-free prescription service means that you do not have to come into the surgery to collect your prescription.

We encourage all patients to register for this free service.

NHS Organ Donor registration

For more information, please ask for the leaflet on joining the NHS Organ Donor Register.

NHS Blood Donor registration

For more information, please ask for the leaflet on joining the NHS Blood Donor Register

Supplementary Questions

Ordinarily Resident

Anybody in England can register with a GP practice and receive free medical care from that practice.

However, if you are not ‘ordinarily resident’ in the UK you may have to pay for NHS treatment outside of the GP practice. Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain’ in the UK.

Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges.

More information on ordinary residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available from your GP practice. Alternatively for more information go to www.nhs.uk/visitingengland.

You may be asked to provide proof of entitlement in order to receive free NHS treatment outside of the GP practice, otherwise you may be charged for your treatment. Even if you have to pay for a service, you will always be provided with any immediately necessary or urgent treatment, regardless of advance payment.

The information you give on this form will be used to assist in identifying your chargeable status, and may be shared, including with NHS secondary care organisations (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovery. You may be contacted on behalf of the NHS to confirm any details you have provided.

I declare that the information I give on this form is correct and complete. I understand that if it is not correct, appropriate
action may be taken against me.

A parent/guardian should complete the form on behalf of a child under 16.

European Economic Area (EEA) Country

For a list of EEA countries visit: www.gov.uk/eu-eea

If you are visiting from another EEA country and do not hold a current EHIC (or Provisional Replacement Certificate (PRC))/S1, you may be billed for the cost of any treatment received outside of the GP practice, including at a hospital.

EHIC/PRC

Please enter the details from your EHIC or PRC below.

S1 Form

Please give your S1 form to the practice staff.

How will your EHIC/PRC/S1 data be used?

By using your EHIC or PRC for NHS treatment costs your EHIC or PRC data and GP appointment data will be shared with NHS secondary care (hospitals) and NHS Digital solely for the purposes of cost recovery. Your clinical data will not be shared in the cost recovery process.

Your EHIC, PRC or S1 information will be shared with The Department for Work and Pensions for the purpose of recovering your NHS costs from your home country.