If you wish to pre-register click on the link below to open the form. When you have completed all of the details please either save to your computer and email to us at CCCCG.firstname.lastname@example.org, print and return to the surgery by post, or bring to the surgery. When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct.
When you register you will also be asked to fill out a medical questionnaire. This is because it can take considerable time for us to receive your medical records. Please complete the Health Questionnaire and either bring it to the Surgery, or email it to us at CCCCG.email@example.com
Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.
WHEN YOU REGISTER AS A PATIENT IT IS IMPORTANT THAT THE FORM BELOW IS COMPLETED AND RETURNED WITH THE REGISTRATION FORM
New Patient Health Questionnaire
New Patient Health Questionnaire Under 16 years