To Register with the surgery please find attached
- GMS 1 Family Doctor services registration form
- Churchill Clinic Registration Form
- Patient online registration form - To book appointments and order repeat prescriptions online
- Patient Consent Form -Authorizing named person/pharmacy to collect prescription on your patient’s behalf. Confirming your consent to leave a message on your telephone contact number and being aware that it is the patient’s responsibility for advising the surgery of any changes regarding consent details.
Proof of identity and proof of address is needed for Adults registration.
- Full Driving License
- Utility Bill
- Tenancy Agreement
- NHS Number – This can be obtained from your previous surgery or found on any Hospital correspondence.
To register a child - age 0 – 5 years old, please provide their red book and NHS Number. Up to the age of 17 years of age please provide the child’s NHS number.
If you were born outside the UK, please provide your passport. If you hold a passport from a country outside the EU, please provide an up to date Visa/right to stay in the UK. Without these documents/information we will be unable to register you.
Please return the completed registration forms along with the necessary paperwork to the Receptionist at the surgery.
We look forward to meeting you and welcome you to the Churchill Clinic