Supplementary questions

Use this service if you are not ordinarily resident in the UK; you may have been asked to complete this form as part of your registration.

You can use this service if you:

• have filled in a complete new patient registration form
• want to register at the surgery
• live within our catchment area
• have been asked to do so

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of

Start now

You can also phone us on 0121 551 4220.