New Patient Registration

If you live within a 5 mile radius of Greyfriars Surgery, then you are welcome to register with us. To register please complete the online form. You will need to provide us with photographic I.D and a letter with your name and address on it (e.g. driving license/passport and utility bill)

Section 1 - Who is registering?

 

Are you registering Required

Only provide your details if you are registering someone else.

Section 2 - Details of patient registering

 

Required
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Date of Birth Required
What is your sex as recorded on your NHS record? Required
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Current Address Required
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Name and address of UK GP surgery you registered with
Is this your first GP surgery in the UK? Required
Have you ever lived somewhere else in the UK? Required
Last address in the UK
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Section 3 - Patients under 18 years

 

For children under 12 months only

Where were they born?
Where was the mother living when the baby was born?

For patients under 18 years

Do you attend any of the following?
Address
Are any of these involved in your care?
Have you had all your routine vaccinations?
Did you get your routine vaccinations in the UK?

Section 4 - Additional information

 

What is your ethnic group? Required
Have you registered with a UK GP before? Required
If you have moved to the UK, what date did you arrive?
Have you ever served in the UK Armed Forces or were you ever registered with a Ministry of Defence GP in the UK or overseas? Required

If you were given a FMED133A form (sometimes called an FMED1 form) when you left the UK Armed forces, you should give this to your GP surgery. 

Do you need an interpreter for your appointments? Required
Are you a carer? Required
What type of carer are you?
Do you have a carer? Required
What type of carer area they?
Required
What pharmacy do you want your prescription sent to? Required
Do you live more than 1 mile from your nearest pharmacy? Required
Would you have serious difficulty getting medicines or appliances from your nearest pharmacy? Required
Do you want important information from your GP record to be available to other health and care professionals? Required

Your GP surgery needs permission to share important information from your GP record. This is called a Summary Care Record (SCR). Your SCR can only be shared with health and care staff across England who are providing you with direct care. It gives them access to vital information from your GP record. 

Section 5 - Patient health

 

Have you ever had any of these conditions?
What best describes you?
What date did you stop smoking?

If you are currently smoking:  Smoking can lead to many complications within your body including heart/ breathing problems and cancer.

OneYou Lincolnshire offers a smoking cessation service. To contact them please call 01522 705162 

How often do you drink alcohol?
How often have you had six or more units of alcohol on a single occasion in the last year?
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Required
Are any of these repeat prescriptions?

Section 6 - Patients from abroad

Complete this section if you are:

  • visiting the UK and do not normally live here.
  • currently living in the UK, but do not think of it as your permanent country of residence. For example, you are studying here or have come to the UK as part of your job. 
  • a permanent resident in the UK and receive a pension or benefit from a European country. 

Information on eligibility to free care outside the GP practice

Anyone can register with a GP practice and receive free medical care from that practice. However, should you be referred for treatment outside the practice or need unplanned care, for example at a hospital, charges may apply if you are a visitor or temporary resident. 

Some groups of visitors or temporary residents are eligible to receive this care free of charge. Documentation may be required to demonstrate eligibility. 

Examples of those eligible include:

  • refugees, asylum seekers, those receiving certain forms of state support
  • suspected or confirmed victims of modern slavery and human trafficking
  • temporary residents with a valid visa of over 6 months. You may have paid the immigration health surcharge with your visa application. Note that assisted conception services remain chargeable to this group
  • visitors from the EEA will need to provide their EHIC (European Health Insurance Card), which covers immediately necessary unplanned treatment, or a S2 form which covers planned treatment. 

Additionally, some services are free of charge to all visitors, including diagnosis and treatment for infectious diseases and sexually transmitted infections. 

Immediate necessary care, maternity care and other urgent care that cannot wait until a chargeable visitor's departure from the UK will not be withheld or delayed due to charges. But non-urgent treatment will not be given until full payment is received. 

More information can be found in the patient leaflet available from the GP practice.

Select the statement that applies to you
Tick one of the following

Enter details from your EHIC

Date of birth
Expiry date

Section 7: Further Information

Marital Status Required
Employment Status Required
Pleas tick here if you DO wish to sign up to the following services Required

By agreeing to sign up to online services, you are agreeing to the surgery sending your online login details through the post once you are registered.

For Women Only

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

 This information is retained for up to 28 days.

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