If you would like to register as a new permanent patient with Whitwell Surgery please complete the form below.
Please complete the form with the details of the patient you are registering. If you completing a patient registration on behalf of somebody else, including a child you parent, please provide their details not yours. If you are registering a child under the age of 13 please provide your contact details.
Before seeking to register as a permanent patient with Whitwell Surgery, please check that you are living within our practice boundary. If your address is outside of our boundary you will not be able to register with us and will need to apply to register with a different GP practice.
Please note: once you have submitted the form we ask you to come into the Surgery within 7 working days, with one form of photo ID such as valid passport or drivers’ licence and with a proof of address, such as a utility bill addressed to yourself and dated within the last three months. This helps us to confirm the details that you have provided on your form.