New Patient Registration

New Patient Registration

If you live within our boundary area and would like to register with the practice please use this form. We will invite you to come in to the surgery to sign some additional paperwork before the registration process is complete. Please let us know if this is difficult for you in any way and we will try to help.

Special Circumstances

We understand that it might be difficult for some people to fill in this form or to provide the personal or address identification that we request. Please come in to the surgery and we will do our best to help you.

Visit www.nhs.uk:NHS Services to view information on NHS GPs services and Registering with a GP.

Temporary Registration

You can register temporarily with a GP if while away from home for work, study or holiday if you need medical care that can not wait until you return home. You’ll still remain registered with your permanent GP.

New Patient Registration

Patient's Details

Title *
Please use this date format: DD/MM/YYYY.
Are you a student?
Please use your current Manchester address.
Please use your current Manchester address.
Please use your current Manchester address.
Do you consent to us sending you text messages relating to your care e.g. appointment reminders and when we need you to contact the surgery?
Any responses we send will go to this email address.
Can we contact you by email?
Are you registering a child? *

Child Registration

Does this child attend a Local Authority School? *
Is this child home schooled? *