Step 2: Provide documentation

As part of the New Patient Registration and registering for Online Services please upload:

Complete Ethnicity Form (download below)
Completed new patient health questionnaire (download below)

Once these are completed please send or drop theses in to the surgery.

Please allow 10 days before your registration will be complete and speak to the practice to confirm your registration. Please ensure that you have enough medication from your old surgery, so that you do not run out whilst waiting to register with us.

File upload

First Name *

Last Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

File Upload *

Maximum file size: 5MB

Please upload your files to the practice here. We accept tiff, jpg, png, gif, txt, Word and pdf files, up to a total upload size of 5MB.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

The internet is not a secure place, however, we have gone to great steps in making sure the information you submit to us is as secure as possible. We use SSL (Secure Socket Layer) certificates to encrypt the communication between your computer and our web server. If you are not completely happy to provide information via the internet please contact the practice directly.

I consent to the practice collecting and storing my data from this form.

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