New Patient Registration - Care Home Residents

Before new patients can be taken onto our list, registration forms and a patient history form must be completed and you will have to attend the practice for a simple health check.

If this is your first time registering in the UK you should bring with you proof of your eligibility, for example a document bearing your NHS number or, failing that, your passport.

Before any medication can be issued you must be seen by one of the doctors or nurse practitioners.

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Date of Birth Required
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It is your responsibility to keep us updated with any changes to your telephone number, email & postal address. We may contact you with appointment details, test results or health campaigns

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Next Of Kin Details

Required
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Please help us trace your previous medical records by providing the following information

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NHS Organ Donor registration

Please tell your family you want to be an organ donor. If you do not want to be an organ donor, please visit www.organdonation.nhs.uk or call 0300 123 23 23 to register your decision.

I want to register my details on the NHS Organ Donor Register as someone whose organs/tissue may be used for transplantation after my death. Please select the boxes that apply.

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NHS Blood Donor registration

Would you like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood.

Have you given blood in the last 3 years

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Registration Details

Ethnicity Required
Religion Required

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Communication Needs

Required
Do you need an interpreter? Required
Do you have any communication needs? Required

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Medical History

Have you suffered from any of the following conditions?

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Allergies

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Current Medication

Are you on regular medications? Required
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