Register for Online Services

To register for our online services you will need to complete this form and then visit the practice, bringing  with you two forms of identification. One of these items should include your photograph.

We will then issue you a username and password.

Once you are registered you will be able to use the service to:

  • Order your repeat prescriptions
  • Make an appointment
  • Cancel an appointment
  • Change your contact details
  • Review your medications and known allergies

Register for Online Services

Section

Which surgery is normally attended?
I wish to have access to the following online services (please tick all that apply): *

Terms and Conditions

I understand that it is my responsibility to keep my account secure by keeping my details confidential. I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records. I understand that my registration will be revoked if I constantly miss or cancel appointments.

I wish to have online access and understand and agree with each statement:
 
  • I will be completely responsible for the security of the information that I see or download.
  • If I choose to share my information with anyone else, this is at my own risk.
  • I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement.
  • If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible.
  • I confirm I will provide two forms of ID.