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Pre-Registration with the practice

PreRegistrationIf you qualify for registration and wish to pre-register click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us.  You will then need to telephone the surgery on 0161 736 1616/1021 or Victoria Road surgery on 0161 789 3722 to arrange your new patient check appointment, we cannot complete your registration until you have attended this appointment. When attending your appointment we will need you to bring in a form of identification.

PLEASE NOTE THAT IF YOU ARE OUTSIDE OUR COVERAGE AREA, REGISTRATION WILL BE REFUSED.

Pre-registration Form

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Online medical questionnaire for new patients

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

 


Alternatively you may print off a registration form, fill it out and bring it in with you on your first visit to the practice.

 

Registration Form

 

 
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