Sunday, September 05, 2010
How Do I... Join the practice Online Registration

Online Registration

New Patient Registration

To become a new patient at Barton Surgery you need to complete the following form. This can be done on-line or if your prefer, you can use the print button at the top of the page and then post it or hand it in at the surgery.

Please note that you will need to attend the practice for your height and weight to be taken. You will also need to bring proof of identity with you i.e. utility bill, passport, photographic driving licence.

Your registration will not be complete until you have your intake appointement at the surgery.

Patient Details
Title: *
Please make a selection from the list.
Surname: *
Please enter your surname
First Names: *
Please enter your first names.
Previous Surname/s
Birth Date *
Invalid Input

Please enter dates as numbers - dd.mm.yyyy Example 31st December 1958 would be 31.12.1958
Town of Birth *
Please enter the name of the town where you were born.
Country of Origin: *
Invalid Input
Home Address *
Please enter your house name or number and the street name.
Town *
Please enter the town where you live.
Post Code *
Please enter your post code
Contact Tel. No:
Please enter a contact phone number.
Email Address:
Please enter a valid email address.

If you have been registered at a previous surgery please help us trace your records by providing the following information...
Your Previous Address:
Invalid Input
Name of Previous Doctor:
Invalid Input
Address of Previous Doctor
Invalid Input

If you have moved from abroad please provide the following information...
Your first UK address registered with a GP:
Invalid Input
If previously resident in UK, date of leaving:
Please enter date of leaving UK in alphanumeric format.
Date you first came to live in UK:
Invalid Input

If you are returning from the Armed Forces please provide the following information:
Address before enlisting:
Invalid Input
Service Personnel Number:
Invalid Input
Enlistment Date
Invalid Input

Please enter dates as numbers - dd.mm.yyyy Example 31st December 1958 would be 31.12.1958

NHS Organ Donor Registration

I would like to join the NHS Organ Donor Register as someone whose organs may be used for transplantation after my death.
Invalid Input

What happens next?

On receipt of your completed application we will send you a New Patient Pack, which will give you further details on the practice.