New Patient Registration

Registration

To register with the practice please ask one of our receptionists for a registration pack or download it from below. The pack contains all of the necessary forms that must be completed as part of the registration process. The completed forms should be handed to our registration clerk. All patients have the right to express a preference as to which doctor they are registered with. Whilst we will endeavour to comply with specific requests, it may not always be possible and, if this is the case, an explanation will be offered.

New Patients

New patients can register with us by coming into the surgery at Buckland House, Esher Park Avenue, Esher, KT10 9NY, to pick up a registration pack. For NHS patients, we will require your NHS number along with your proof of address.

For Private patients, we will require your proof of address and a copy of your passport/Visa.

Registration Pack

Please Note; both the GMS1 Registration form and the New Patient Questionnaire need to be completed to process your registration.

GMS1 Registration Form (.pdf)

New Patient Questionnaire 2017 (.docx)

New Patient Under 16 Questionnaire 2017 (.docx)

Your Neighbourhood Professionals. Just a Click Away! Counselling: why wait for a NHS appointment? Contact a private counsellor today Looking for residential or nursing care? Wanting a home from home? Then check out your local options and book a visit/tour today Need care but want to stay in your own home? Don Surrey Mobile Massage
Buckland House, Esher Park Avenue, Esher, Surrey, KT10 9NY
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Your Neighbourhood Professionals. Just a Click Away! Counselling: why wait for a NHS appointment? Contact a private counsellor today Looking for residential or nursing care? Wanting a home from home? Then check out your local options and book a visit/tour today Need care but want to stay in your own home? Don Surrey Mobile Massage
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