Register for Online Services

To register for our online services you will need to complete this form, you will be sent a username and password in the post. Alternatively you can register for the NHS App.

  • Register for Online Services

    Date of Birth
    For example, 15 3 1984
    Which online services would you like access to? (tick all that apply)
    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.
The information you provide on this form will be sent to our practice and used only to deal with your request. Depending on the form, this may include your contact details, personal information and health information. The practice may add it to your medical record and, where needed for your care, share it with other NHS and care services. To find out how we protect and use your information, please read our privacy policy on our website.
This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Page last reviewed: 11 March 2025
Page created: 02 November 2026