Register for Online Services

To register for our online services you will need to complete this form and then visit the practice, bringing with you two forms of identification. One of these items should include your photograph and one needs to show recent proof of your address such as a utility bill or bank statement.

We will then pass your registration form to our patient services team for processing and will email you the information that you need in order to register your account.

Please ensure that when you fill in this form you supply us with your current email address – please note we need separate and unique email addresses for our patients due to the nature of our online services.

Once you are registered you will be able to use the service to:

  • Book appointments
  • Request repeat prescriptions
  • Access your medical records

Patient Information

Register for Online Services

Please use this date format: DD/MM/YYYY.
(NOTE: By supplying this email address you are giving authority for your online access sign up details to be emailed to this address - each patient MUST have their own email address)
(If child under 16 years)

For medico-legal reasons, before we are able to permit you access to your medical records summary, we require two separate forms of ID to verify both your identity and your address which you must present in person for verification by one of our reception staff.

Acceptable forms of photo ID are a passport or photo driving licence and proof of address can be in the form of a recent utility bill (not mobile phone), bank statement, tenancy agreement or council tax bill etc.

Your details will then be passed to our patient services team who will email you the information you need to register your account.

If you already have an online account which you use to book appointments and/or request repeat prescriptions, then you can use your existing user credentials and additionally have access to view your medical records summary once you have activated this facility.

For Practice Use Only

To confirm patient does not have any physical or mental illness, meaning that to view their medical notes will cause serious physical or mental harm to the patient or another person.
To confirm child under 16 years is Gillick Competent to have own access