Online 'Pre-Registration' With The Practice
If you wish to pre-register click on the links below to open the forms (both-registration and online Medical Questionnaire). 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 you will be asked to sign the form to confirm that the details are correct. Please also email us the data opt-out form duly completed to email@example.com Thank you
When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.
Online Medical Questionnaire For New Patients
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.
Opt out data form
Summary Care Record data sharing during Covid-19 pandemic
When sending us your online request to register we will need you to complete the data sharing form above. Please complete this and email it to firstname.lastname@example.org where we can tie this up with your submitted forms. Thank you