In order to provide for your care we need to collect and keep information about you and your health in your personal medical record. Please complete the following form carefully. The information will be used to create your personal medical record on the practice computer.
Our practices are consistent with the Medical Council guidelines and the privacy principles of the Data Protection Acts. For further details please see our Privacy Statement.
Once submitted, we will process your details and then contact you to book an introductory appointment with one of our GPs. If the GP is satisfied that our clinic will be able to meet your medical needs, they will accept you as a patient and ask you to sign the consent to obtain medical records from your current GP. If the doctor feels the clinic is not a good match for your needs, they will inform you the reason why.
Please note that adults must complete their own separate form to register, however children can be included on a parent's application.
If you would prefer to submit the form in writing, please contact reception for a form.
The practice would like to contact you by text message (SMS) regarding appointment reminders, test results and practice updates.
By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.
