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Register for online services

Register for Online Services
Required fields are labelled
Who are you completing this form for?
For example, on behalf of a child or dependent
What is your name?
What is your date of birth?
For example, 31 3 1980
What is your sex?
As recorded on your medical record
The one used to register with your GP
Anyone else with access to your email account may see responses sent to you
Please specify which number you have provided: Required
Preferred contact method: Required

Terms and Conditions

  • I understand that it is my responsibility to keep my account secure by keeping my details confidential
  • I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records
  • I understand that my registration will be revoked if I constantly miss or cancel appointments.
Required