New Patient Registration Form

Please complete the New Patient Registration form found below.

It takes up to 10 working days to process your registration. To avoid delays, please provide all the information requested – otherwise our admin team will have to contact you for queries or missing information – together with all up-to-date contact details.

Once your registration is complete, you will become a registered patient at Clerkenwell Medical Practice and will be able to access our full range of services that include completing a website eConsult for the doctor, booking an appointment with a member of our team and requesting your repeat medication. Please note: should you have an urgent health issue that really cannot wait and you believe needs to be dealt with urgently, please contact a member of our admin team who will be able to help if your registration is still being processed.