Registration Forms - Alrewas Surgery

If you live within the practice area and would like to register with the practice, please call into the surgery and our receptionist will give you a registration pack with the relevant forms to complete.

You can also print the forms from the links below.

Temporary resident form (less than 30days)

Registration forms you can print, complete and bring into the surgery

For each person who wishes to register, the following forms are required:

1. A GMS1 form – click on the link:

GMS1 form

2. A New Patient Questionnaire – please ensure you print the correct form:

New Patient Questionnaire OVER 16 YEARS

New Patient Questionnaire UNDER 16

3. If you have a child under 5, you will be given another form to complete when you come into the surgery

4. A form to tell us how you wish to share your information.

This is called the Sharing Care Records Form. For information on your choices download the Sharing your Information Patient Guide.

5. For access to Online Services please see the Online Services menu option above for details.