Application for Out of Area Registration (Without Home Visits)

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If you are a currently registered patient moving outside the practice catchment area, it is now possible to apply to re-register with us as an 'out of area' patient. You would still be able to access most services by our practice but not home visits by a clinician from this practice.

You should consider this type of registration carefully in light of your current medical circumstances. If you subsequently require a visit to your home by a GP out of hours or at the weekend you would need to telephone NHS 111 who will direct you to a walk in centre or a more local GP in your area.

How to Apply as an 'Out of Area Patient'

To enable this you must already be registered at this practice and then de-register and apply for registration again under the new category using the registration form below.

Your request will be considered and we will provide you with a decision within 7 working days.

If at some point in the future your medical condition changes, you may require more local consultations or need home visits. In these circumstances the practice reserves the right to review your registration status.

Patient's Details

Out of Area Registration

Information we need to register you with the practice
Please note all fields marked with a * are mandatory for your registration

This form is for currently registered patients only. If you are registering for the first time please complete our standard registration form found on the link below.

NEW PATIENT REGISTRATION FORM

 
 
 
  
  
   
Previous Details
Please include postcode
If you are from abroad
Please use this date format: DD/MM/YYYY
If you are returning from abroad

Previously been registered with the NHS in the UK

Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Were you ever registered with an Armed Forces GP

Footnote: These questions are optional and your answers will not affect your entitlement to register or receive services from the NHS but may improve access to some NHS priority and service charities services

 
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Identification Upload

Patient Identification

To fully register you at the practice, we need Two forms of Acceptable ID (if not possible, please let us know).

We will not store these documents and we will securely delete / destroy them after our initial verification.

OPTIONAL: Photo of your face to add to your records to help us identify you (if you agree)

Acceptable Identification: Photo Driving License, Passport, Tenancy agreement, Mortgage statement, Bank statement, Utility bill (date within the past 3 months) etc.

Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
 
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NHS Organ Donor registration

For more information on organ donation please visit: www.organdonation.nhs.uk

NHS Blood Donor registration

If you would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood, please visit their website on: www.blood.co.uk or call direct on 03001232323

What happens to my information?

Personal and medical information about patients registered at this practice are primarily kept electronically, although some is kept in paper form. Some information will be sent to hospital consultants and other health professionals to whom you are referred by your GP in order to provide continued healthcare and obtain treatment for you.

We sometimes use accredited suppliers for our communication with you, for example when we send recall letters for review clinics or medication reviews. All suppliers we use are checked carefully to ensure they comply with strict confidentiality protocols.

To ensure the security of all patient information, all staff that has access to your records is covered by confidentiality clauses in their contracts and the Data Protection Act and the Freedom of Information Act. Our guiding principle is that we hold your records in strict confidence.

I certify that the information I have provided is correct and consent to my personal and medical information being used as stated above.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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