New Patients Registration Form

We are happy to register new NHS patients within our practice boundary area.

How to Register

IMPORTANT NOTICE –

Patients must complete  both the GMS1 form and New Patients Questionnaire  and provide Proof of address and ID. This information  must be emailed to  golden.abu@nhs.net

Failing to do this will result in you not being registered at the Practice. Any incomplete registration forms will be discarded  after 10 days.

BEFORE COMPLETING THE REGISTRATION FORMS  PLEASE MAKE SURE THAT YOUR POSTCODE FALLS IN OUR BOUNDARY T AREA. WE ARE UNABLE TO REGISTER PATIENT WHOSE POSTCODE IS OUT OF OUR   BOUNDRY AREA

Adult Registration Form  16+
Baby and Child Registration

After you have completed and submitted the GMS1 Registration form you must complete the relevant downloadable New Patient Questionnaires above, and attend the surgery within 7 days with these completed and two forms of identification. During Covid 19 Please email the New patient questionnaire to golden.abu@nhs.net.

Acceptable identification includes:

  • Passport
  • Birth Certificate
  • HC2 Certificate
  • Rough sleepers’ identity badge
  • Hostel Registration/mail forwarding letter.
Until we have seen your identification you will not be registered at the practice.

For further information on registering with your GP, please visit the NHS website.

NHSFamily doctor services registrationGMS1

Patient's Details

Please use this date format: DD/MM/YYYY.

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

If you are from abroad

Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.

If you are returning from the armed forces

Please use this date format: DD/MM/YYYY.

If you are registering a child under 5

If you need your doctor to dispense medicines and appliances*

*Not all doctors are authorised to dispence medicines

NHS Organ Donor registration

For more information, please ask at reception for an information leaflet or visit the website www.uktransplant.org.uk, or call 0300 123 23 23.

NHS Blood Donor registration

For more information, please ask for the leaflet on joining the NHS Blood Donor Register

Supplementary Questions

Ordinarily Resident

Anybody in England can register with a GP practice and receive free medical care from that practice.

However, if you are not ‘ordinarily resident’ in the UK you may have to pay for NHS treatment outside of the GP practice. Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain’ in the UK.

Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges.

More information on ordinary residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available from your GP practice. Alternatively for more information go to www.nhs.uk/visitingengland.

You may be asked to provide proof of entitlement in order to receive free NHS treatment outside of the GP practice, otherwise you may be charged for your treatment. Even if you have to pay for a service, you will always be provided with any immediately necessary or urgent treatment, regardless of advance payment.

The information you give on this form will be used to assist in identifying your chargeable status, and may be shared, including with NHS secondary care organisations (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovery. You may be contacted on behalf of the NHS to confirm any details you have provided.

I declare that the information I give on this form is correct and complete. I understand that if it is not correct, appropriate
action may be taken against me.

A parent/guardian should complete the form on behalf of a child under 16.

European Economic Area (EEA) Country

For a list of EEA countries visit: www.gov.uk/eu-eea
For more information about the European Health Insurance Care (EHIC), visit: www.nhs.uk/ehic.

If you are visiting from another EEA country and do not hold a current EHIC (or Provisional Replacement Certificate (PRC))/S1, you may be billed for the cost of any treatment received outside of the GP practice, including at a hospital.

EHIC/PRC

Please enter the details from your EHIC or PRC below.

S1 Form

Please give your S1 form to the practice staff.

How will your EHIC/PRC/S1 data be used?

By using your EHIC or PRC for NHS treatment costs your EHIC or PRC data and GP appointment data will be shared with NHS secondary care (hospitals) and NHS Digital solely for the purposes of cost recovery. Your clinical data will not be shared in the cost recovery process.

Your EHIC, PRC or S1 information will be shared with The Department for Work and Pensions for the purpose of recovering your NHS costs from your home country.