NHS Family doctor services registration
GMS1


If you do not reside within our practice boundary you will receive a notification from our registration team informing you of your options.

Your registration will be completed within 5 working days of submission of your registration form. Our registration team will contact you by email to inform you of your registered GP.

Which GP would you prefer to be registered with? *
Title *
Required
Surname *
Your answer
First names *
Your answer
Date of birth *
MM
/
DD
/
YYYY
NHS no
Your answer
Previous surnames
Your answer
Town and country of birth *
Your answer
Home Address *
Your answer
Post Code *
Your answer
Telephone Number *
Your answer
Email address
This will enable us to sign you up to patient online services
Your answer
Ethnicity *
Your answer
First Language *
Your answer
Do you require an interpreter? *
If yes please state which language
Your answer
Have you been registered with St Andrews Medical Centre previously? *
Do you have any family members registered with St Andrews - If so please state name and DOB
Your answer
PLEASE HELP US TRACE YOUR PREVIOUS MEDICAL RECORDS BY PROVIDING US WITH THE FOLLOWING INFORMATION
Your previous address in the UK (if the same please state 'as above') *
Your answer
Name and address of previous GP while at that address *
Your answer
IF YOU ARE FROM ABROAD
Your first UK address where registered with a GP
Your answer
If previously resident in UK; date of leaving
MM
/
DD
/
YYYY
Date you first came to live in the UK
MM
/
DD
/
YYYY
IF YOU ARE RETURNING FROM THE ARMED FORCES
Address before enlisting
Your answer
Service or personnel number
Your answer
Enlistment date
MM
/
DD
/
YYYY
IF YOU ARE REGISTERING A CHILD UNDER 5
I wish the child above to be registered with the doctor named overleaf for Child Health Surveillance
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