PLEASE  NOTE  THAT  WE  ARE  UNABLE  TO  PROCESS  INCOMPLETE  REGISTRATIONS

PLEASE ENSURE ALL ASPECTS OF THE REGISTRATION FORM ARE COMPLETED. FAILURE TO DO SO WILL RESULT IN YOUR REGISTRATION BEING REJECTED AND RETURNED TO YOU FOR COMPLETION

To ensure the smooth transition to Headcorn Surgery, we do ask that you contact your current surgery to request a patient summary. You will be need to upload this during the completion of this registration form.

Please also ensure that you have adequate medication from your current surgery before registering with us. It can take around 4 weeks for us to receive your medical notes from your previous surgery.

Before filling out this form, please have ready the following items for uploading:

  1. Patient summary from your previous surgery
  2. Medication list  (if relevant) - your medication list may already be included in your patient summary
  3. Two forms of identification  - e.g. Photo driving license, passport, bank statement, tenancy agreement, mortgage statement, utility bill (dated within the past 3 months) etc.

Thank you for your assistance. 

Please click on the button below to take you to the registration form

Registration Form