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Online 'Pre-Registration' With The practice

PreRegistrationTo register with the Whiteley Surgery, please print off the form below, fill it out and bring it in to the surgery - please remember to bring your photo ID and proof of address.

We also have a Health Questionnaire in the Registration Pack which we would like you to complete and return with the Registration Form.

When you give us the forms, you will be invited to attend a New Patient Health Check. This is because it can take a considerable time for us to receive your medical records.  If you take regular medication, please bring along the repeat medication slip from your previous practice.  This will greatly speed up the process of providing you with future medication.


PLease select from the below list the most appropriate registration form.

Adult click here

Adult (large print) click here

Children under 16 click here

children under 16 (large print) click here

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