Registration

We register anyone eligable for NHS treatment who is living in our catchment area (the whole of EC1 + EC2 + small parts of WC1 & N1 see map) and all students living in the City University Halls of Residences in EC1 & N1.

We prefer to register all persons or family members living at your address in order to offer full care.

Please print off and complete the forms below. (click to view in Acrobat format) *Click back arrow to get back to this page from forms below.

n.b. Although the information provided on the ethnic monitoring form is voluntary, if you choose not to provide your ethnicity, we do still need the form handed in and signed so that we can record that you have opted out.

• Registration and Summary Care Record Consent form *
• New Patient Health Check Form
• Ethnic Monitoring Form
• Alcohol Questionnaire 

*Please read THIS information provided about Summary Care Records.

Please complete the above forms on line, print them ALL off and sign them.  Bring all the forms along to the surgery with proof of address and ID where we will check the forms and we will then register you. *If you have your NHS Number then please add this on to the Registration Form.

Please choose the appropriate form for your Halls of Residence, along with the Health Check Questionnaire and Ethnic Monitoring forms:

• Registration and Summary Care Record Consent form *
• New Student Patient Health Check Form
• Ethnic Monitoring Form
• Alcohol Questionnaire