Online New Patient Registration Process

NHSFamily doctor services registrationGMS1

Radio Buttons *

Mrs

Miss

Surname *

Date of Birth *

DD/MM/YYYY

First names *

NHS Number

Previous surnames

Radio Buttons *

Male

Female

Town and country of birth *

Home address *

Postcode *

Telephone number

Your previous address in UK

Name of previous doctor while at that address

Address of previous doctor

Your first UK address where registered with a GP

If previous resident in UK, date of leaving

Date you first came to live in UK

Address before enlisting

Service or personnel number

Enlistment date

Child Surveillance

I wish the child above to be registered with the doctor named overleaf for Child Health Surveillance

Checkboxes

Signature

Signature of behalf of Patient

Date

Highview Medical Centre

	On the day	Patients can book an appointment on the day from 8am by calling 01707 871 980 or via our Online Services.
	Online Appointments	Patients can book an appointment up to 2 weeks in advance via our Online Services.
	Out of Hours	If you have an urgent health problem which cannot wait until the surgery is open please call 111.
	Telephone Appointments	Telephone Consultations can be booked with a doctor of your choice. These are useful for medication queries and general advice; to book please call 01707 871980.