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 Pre-registration with the practice

If 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. You MUST attend the surgery for a new patient check and sign the registration form before we can accept you as a registered patient. Please contact Reception on 0121-308 2080 to book a New Patient Check with one of our Nurses.


Pre-registration Form


When you register you will also be asked 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, which you may fill out and bring with you to your New Patient Check appointment. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Online medical questionnaire for new patients

Note that by sending the form you will be transmitting information about yourself 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 bring it in with you. We are unable to register you without a signed registration form, so we advise that you attend the surgery with your signed registration form and book your New Patient Check.

 

Registration Form

 
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