Online 'Pre-Registration' With The Practice

PreRegistrationIf 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. 

You must complete a pre-registration form and a questionnaire below (if applicable) to register  

Pre-registration Form

Adults New Patient Questionnaire for Registration 16 years and over

Childs New Patient Questionnaire for Registration 0-15 years - not required for patients born in England

When you register you also need fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. Please download this above, complete and email to us at gpccg.lythamroadprescriptions@nhs.net.

You must complete BOTH forms above to register.

Please note registrations can take up to 7 days to be processed once we have received all the registration documents.

When you visit the surgery for the first time you will be asked to sign the forms to confirm that the details are correct.

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 send it to us with your New Patient Questionnaire

pdfRegistration Form

 
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