How to register

Catchment Area

New Patient Questionnaire

We will ask you to fill in a questionnaire when you register to enable us to gain important information about you as a new patient.  This is necessary because your records may take some time to reach us from your previous doctor.  We will also require pictorial evidence of your identity together with a document sent to you at your home address.

Our team will review your questionnaire and you will be contacted if necessary. It is important that you complete all of the sections on this questionnaire. Our reception team will be happy to help with any queries.

Online Registration

Alternatively, you can complete the forms below:

New Patient Registration Form

Registration Form (Adult)

New Patient Registration Form

Please Note: A supporting signed letter from the patient will be required either posted or emailed to the practice, to complete the registration.

1. Background Details

Contact Details

Address
Address
Postcode
City
Country
Previous Address
Previous Address
Postcode
City
Country

I consent to be contacted* by SMS on this number

I consent to be contacted* by email at this number

Next of Kin

Has the Patient been registered in the NHS before?
* It is your responsibility to keep us updated with any changes to your telephone number, email & postal address. We may contact you with appointment details, test results, health campaigns or Patient Participation Group details. If you do not consent to being contacted by SMS or Email, please tick here:

Other Details

Previous GP

Address
Address
Postcode
City
Country
Ethnicity
Overseas Visitor
Armed Forces

Communication Needs

Language

Do you need an interpreter?

Communication

Do you have any communication needs?
Please specify below

Learning disability

Do you have a Learning Disability?

(If yes please request a Learning Disability Screening Tool form)

Carer Details

ARE YOU a carer?
Do you HAVE a carer?

Your carer’s details

* Only add carer’s details if they give their consent to have these details stored on your medical record

Page last reviewed: 5 June 2024