Under 16s Online Registration Form

Non-urgent advice: Please note

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

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 ensure all aspects of this registration from are completed.                                               

Failure to do so will result in your registration being rejected and returned to you to complete fully.

Non-urgent advice: Patient Notice

By completing this form you are confirming that you have contacted all individuals mentioned informing them that their details will be added onto your medical records.