New Patient Registration Form (GMS1)V3 and Questionnaire

Fields marked "REQUIRED" are compulsory. You should only send this form if you are sure that you are eligible to join this practice. Sending this form will NOT automatically register you with the surgery. Sending this form does NOT guarantee or even imply that you will be accepted onto the practice register.

Last Updated: 01/02/2024

Patient Details

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

If you are from abroad

If you are returning from the armed forces

New Patient Questionnaire - Personal Details

Medical Information

Living Will / Advance Directive

Other clinical details

Contacting you


NHS Organ Donor Registration

You have a choice about organ or tissue donation after your death. To find out more about why it is important that you take the time to make your donation decision and record it, got to

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.
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