Registering Online

Online 'Pre-Registration' With The Practice

If you wish to pre-register click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us. In order to complete the registration process, you will need to visit the surgery to sign the registration form to confirm that the details are correct. Once the form has been signed you will be registered at the Practice.

Patient Access and Consent Form

Patient Access Consent & Registration form

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.

When you come into the practice to complete your registration you will also be asked to fill out a medical questionnaire about your past/present health, allergies, family history etc. This is because it can take a considerable time for us to receive your medical records.

If you have a long term condition which requires regular review it is advisable that you make an appointment with a Practice Nurse at your earliest convenience. This will help us to obtain important medical information about you whilst waiting for your medical record to arrive.

If you would prefer not to complete the form online, you can print off a registration form, fill it out and bring it into the practice.

Registration Form

Patient Boundary

Surgery Image

Contact Us

Churchtown Medical Centre
137 Cambridge Road
Tel: 01704 224416/224411