This website uses cookies to function correctly.
You may delete cookies at any time but doing so may result in some parts of the site not working correctly.
 

Noticeboard

WE HAVE MOVED:
Our Netherton site is now at Netherton Health Centre, DY2 9PU.
(Branch appointments at Hazel Road continue as normal.)



Prescription Ordering Direct (POD) 01384 323222
Open Monday - Friday, 9am - 5pm

Online 'Pre-Registration' With The Practice

PreRegistrationIf you wish to pre-register click on the links below to open the forms. You will need to complete both the Pre-registration and the Medical Questionnaire form. When you have completed all of the details, click on the "Send" button to mail both forms to us. When you visit the surgery for the first time you will be asked to sign the forms to confirm that the details are correct. We ask you to fill out a medical questionnaire when you register with our practice. This is because it can take a considerable time for us to receive your medical records. If you choose to complete these forms online, you will need to contact the practice by telephone on 01384 239657 to arrange a new patient medical.

Pre-registration Form

Online Medical Questionnaire For New Patients

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.


Alternatively you may print off a registration form, fill it out and bring it in to the practice.

pdfRegistration Form

 
Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website