Online 'Pre-Registration' With The Practice

PreRegistrationIf you wish to pre-register click on the link below to open the form. 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.

When you register you will need 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 below, which you need to 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.

Under 16's require a completed Health Questionnaire also, except for newborns. This can be found as a pdf document below. Please contact us at Reception to submit this.

To register with our practice you will need to complete both of the following forms: (Failure to do so will mean your registration will be delayed until we receive both forms)

Pre-registration Form

Adult (age 16 and over) Health Questionnaire

Under 16 Health Questionnaire

Please note that we will not be able to process your application without both completed forms being submitted.

The registration process can take up to a week so if you need medication urgently you may need to contact your current Practice for this.

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.

Alternatively you may print off a registration form, fill it out and hand it in at reception.


Adult Health Questionnaire

Under 16 Health Questionnaire

Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website