New Patient Registration

If you would like to register with the practice please use this form.

Patients wishing to register with the practice may do so if their address is within the practice catchment area. Practice policy is to register complete households only. Please check our boundary map and if you are in any doubt, please telephone the practice to confirm.

Catchment Area

  • Barton
  • Clophill
  • Flitton
  • Greenfield
  • Gravenhurst (Upper and Lower)
  • Harlington
  • Hexton (Hertfordshire)
  • Higham Gobian
  • Maulden (only part)
  • Pegsdon
  • Pulloxhill
  • Sharpenhoe
  • Shillington
  • Silsoe
  • Streatley
NHSFamily doctor services registrationGMS1

Patient's Details

Please use this date format: DD/MM/YYYY.

Emergency Contact

I give my consent for the person named above to communicate on my behalf with The Surgery staff about my medical affairs. I understand that this could include past and present blood test results, investigation results, referrals, medication and appointments both at The Surgery and hospitals.
This will remain the case until The Surgery is notified in writing otherwise.

Medication

Allergies

Previous Details

Please include postcode.

If you are from abroad

Registering for the first time in the UK

Please use this date format: DD/MM/YYYY.

If you are returning from abroad

Previously been a resident in the UK

Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.

Carers