New Patient Registration

If you would like to register with the practice please use this form.

To register a new patient you will need to live within our practice boundary.

New Patient Registration - Hall Green

Patient's Details

Please use this date format: DD/MM/YYYY.
If you were previously registered at another practice please contact the practice to obtain your NHS No.
Any responses we send will go to this email address.

Nationality

Emergency Contact

Allergies

Previous Details

Please include postcode.

If you are from abroad

Please use this date format: DD/MM/YYYY.
If you are under 3 years old you must have a named health visitor. If you do not have one please call the health visitors on 0121 466 4820.

If you are returning from abroad

Previously been a resident in the UK

Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.

Carers