New Patient Registration
We welcome and register any person living within the Practice area.
Registration forms can be obtained from Reception or you can complete the on-line registration form and questionnaires below (please complete both forms), or download the required forms.
Please note you will be required to produce 2 forms of identification to the Practice, one photographic (driving licence or passport) and one which confirms your current address (utility bill, financial statement)
All new patients over the age of 16 will require a Health Check with either our Health Care Assistant or Practice Nurse. Upon completion of your registration form and questionnaire, a receptionist will contact you to arrange a convenient appointment. This may take up to 4 weeks.
1. GMS1 Registration Form
GMS1 Registration Form download or complete the online form below.
2. Health Questionnaire
Adult Registration Questionnaire download or click here to complete it online.
Under 16 Registration Questionnaire download or click here to complete it online.
Please help us trace your previous medical records by providing the following information
If you are returning from the Armed Forces
If you are registering a child under 5
If you need your doctor to dispense medicines and appliances
Not all doctors are authorised to dispense medicines
NHS Organ Donation registration
For more information, please ask at reception for an information leaflet or visit the website
www.uktransplant.org.uk, or call 0300 123 23 23.
NHS Blood Donor Registration
For more information, please ask for the leaflet on joining the NHS Blood Donor Register.
For all patients who are not ordinarily resident in the UK
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.
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.
A parent/guardian should complete the form on behalf of a child under 16.
Non-Uk European Health Insurance Card (EHIC), Provisional Replacement Certificate (PRC) Details And S1 Forms
Complete this section if you live in another EEA country, or have moved to the UK to study or retire,
or if you live in the UK but work in another EEA member state. Do not complete this section if you have
an EHIC issued by the UK.
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.
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key known only to the GP practice and is
accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.