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Online 'pre-registration' with the practice

PreRegistrationIf 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 email your form to us. When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct.

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. When you come to the surgery, you will be asked to sign this form to confirm that the details are correct.

Please remember to bring proof of photo ID (driving license or Passport) and proof of address (such as a bank statement, utility bill or tenancy agreement) to the surgery before your first appointment. Due to regulations, we are unable to register you without proof of ID and address.

Online medical questionnaire for new patients

 St Clements Surgery New Patient Questionnaire

Summary Record Consent/Dissent form

 

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 on your first visit to the practice.

 
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